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Screening amblyopia of preschool children with uncorrected vision and stereopsis tests in Eastern Taiwan
C-H Chang1, R-K Tsai, M-M Sheu
1Department of Ophthalmology, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
Insights
Early amblyopia screening in children is crucial. Combining distance visual acuity and stereopsis tests improves detection sensitivity, offering better outcomes for amblyopic children.
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
- Public Health
Background:
- Early detection of amblyopia is vital for effective treatment and improved prognosis.
- Population-based screening programs are essential for identifying visual impairments in young children.
Purpose of the Study:
- To evaluate the diagnostic validity of uncorrected distant and near visual acuity and random dot stereopsis for amblyopia screening.
- To determine the optimal combination of tests for sensitive and specific amblyopia detection in children.
Main Methods:
- A population-based screening of 5232 children aged 3-6 years in Eastern Taiwan.
- Tests included uncorrected distance and near visual acuity, and the NTU random dot stereogram (300s).
- Screening was performed by registered nurses, with ophthalmologist examinations serving as the gold standard.
Main Results:
- Individual tests showed varying abnormal rates: distance visual acuity (10.3%), near visual acuity (30.3%), and random dot stereopsis (2%).
- Sensitivities for amblyopia detection were: distance visual acuity (74.7-84.8%), near visual acuity (49.4%), and random dot stereopsis (20.5%).
- Simultaneous testing of two or more tests significantly improved overall sensitivity.
Conclusions:
- Screening for amblyopia using visual acuity or random dot stereopsis tests alone by local nurses lacks high sensitivity.
- Combining distance visual acuity testing with stereopsis testing enhances sensitivity while maintaining specificity for amblyopia screening.
Unlabelled:
AIMS OR PURPOSE: Screening for amblyopia at earliest age is important for early treatment and better prognosis. This study aimed at evaluating the validity of uncorrected distant and near visual acuity and random dot stereopsis for screening amblyopia. METHODS; In Eastern Taiwan, population-based screen tests were performed for children at age from 3 to 6 years. The tests included uncorrected distant and near visions and random dot stereopsis (300 s) test. The screen performers were registered nurses of local public health service posts. The golden standards of the tests were the results of examination by the ophthalmologists.
Results:
Including Hans and aboriginal Taiwanese, 5232 children were included. Screened by distance visual acuity with different cutoffs and near visual acuity, 10.3, 30.3 and 8.2% children were abnormal. Screened by random dot, only 2% children were abnormal. By a senior ophthalmologist, 115 amblyopic children were diagnosed amblyopic. The sensitivities of distance visual acuity with low/high cutoff and near visual acuity were 74.7/84.8 and 49.4%, whereas that of the NTU random dot stereogram was 20.5%. Simultaneous testing of either two of the three tests improved the sensitivity.
Conclusion:
Screening for amblyopia by the local nurses using the visual acuity tests or random dot stereopsis test alone does not display a high sensitivity. Simultaneous testing of distant visual acuity and stereopsis test elevate the sensitivity and preserve the specificity.
