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The Seoul Metropolitan Preschool Vision Screening Programme: results from South Korea
1Department of Ophthalmology, Ulsan University College of Medicine, Seoul, Korea.
Insights
A new preschool vision screening model in Seoul effectively identified various ocular disorders, including refractive errors and amblyopia, in young children. However, improving follow-up rates for referred cases is crucial for program optimization.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Preschool vision screening is essential for early detection of ocular disorders.
- Metropolitan areas present unique challenges for implementing public health initiatives.
- A novel vision screening model was developed for preschool-aged children in Seoul.
Purpose of the Study:
- To evaluate a new preschool vision screening model in metropolitan Seoul.
- To determine the prevalence of ocular disorders in preschool children in this region.
Main Methods:
- A stepwise screening process involving home-based tests and clinic-based re-evaluations was used.
- 36,973 children aged 3-5 years participated in the screening.
- Referral criteria included visual acuity thresholds and questionnaire responses.
Main Results:
- 19.2% of children failed initial home screening, with 28.9% of those referred for further evaluation.
- Ophthalmological examination results were available for 43.4% of referred children.
- Prevalence rates included refractive errors (1.6%), amblyopia (0.4%), and manifest strabismus (0.01%).
Conclusions:
- The implemented preschool vision screening model demonstrated high accessibility and ease of use.
- The model was effective in detecting diverse ocular conditions.
- Low follow-up rates for referred children necessitate program optimization.
Aim:
To report on a new model of preschool vision screening that was performed in metropolitan Seoul and to investigate the distribution of various ocular disorders in this metropolitan preschool population.
Methods:
Vision screening was conducted on 36 973 kindergarten children aged 3-5 years in a stepwise manner. The first step was home screening using a set of five picture cards and a questionnaire. The children who did not pass the first step (VA <0.5 in at least one eye or any abnormal responses on the questionnaire) were retested with regular vision charts at the regional public healthcare centres. After this retest, some children were referred to ophthalmologists. The referral criteria for visual acuity were <0.5 at 3 years and <0.63 at 4 or 5 years in at least one eye.
Results:
Of those screened, 7116 (19.2%) children did not pass the home screening tests and 2058 (28.9%) out of the 7116 were referred. The results of the ophthalmological examination in eye clinics were only available for 894 children (43.4%) of those who were referred. The rest of the children did not visit ophthalmologists because they had been checked at an eye clinic, were currently under treatment, or for personal reasons. Refractive errors were found in 608 (1.6%) children. Astigmatism was associated in 78.2% of ametropes. Amblyopia was discovered in 149 (0.4%) children and refractive error was the major aetiology with a predominant rate (82.5%). Manifest strabismus was detected in 52 children. The positive predictive value of vision screening for any ophthalmological disorder was 0.77, and 0.49 for significant disorders requiring treatment.
Conclusions:
This preschool vision screening model was highly accessible to the children and their parents, easy to administer, and effective to detect a variety of ocular disorders. However, the participation rate of the referred children in the examinations by ophthalmologists was quite low. The performance and efficiency of this screening programme need to be optimised with further revision.
