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Effectiveness of vision-screening in pre-school populations with preferential-looking cards used for assessment of
1Exceptional Child and Infant Vision Testing Laboratory, Ohio State University College of Optometry, Columbus.
Insights
Vision screening in preschoolers using the Modified Clinical Technique (MCT) and preferential-looking (PL) cards effectively identifies vision problems, enabling early intervention for better visual development.
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
- Public Health
Background:
- Early identification and intervention of vision problems in preschoolers are crucial for normal visual system development and learning.
- Vision screening in pre-school populations is recommended to facilitate timely detection and treatment of visual impairments.
Purpose of the Study:
- To evaluate the effectiveness of the Modified Clinical Technique (MCT) for vision screening in preschool children.
- To assess the utility of preferential-looking (PL) cards for measuring monocular visual acuity in young children.
Main Methods:
- A masked investigation screened 119 preschool children (mean age 3.51 years) using the Modified Clinical Technique (MCT).
- Monocular visual acuities were measured using preferential-looking (PL) cards.
- Statistical analysis included Fisher's Exact Test with Bonferroni correction to compare acuities between referrals and non-referrals.
Main Results:
- All 119 children completed monocular visual acuity assessments.
- Acuities were significantly better in non-referrals compared to referrals (p < 0.0167).
- The screening technique showed high effectiveness (phi = +0.94) with a referral criterion of 6/12 (20/40) or less in either eye and/or a 2-octave interocular difference.
- The referral rate was 17.6%, higher than predicted but consistent with the study population.
- Preferential-looking (PL) cards enabled 100% successful monocular visual acuity measurement, enhancing screening effectiveness.
Conclusions:
- The Modified Clinical Technique (MCT) combined with preferential-looking (PL) cards is an effective method for preschool vision screening.
- PL cards facilitate accurate monocular visual acuity measurement in young children, improving screening outcomes.
- Early vision screening is vital for identifying potential developmental issues and ensuring timely intervention.
Abstract:
Screening the vision of pre-school populations has been suggested as a way to assure early identification of vision problems as well as early intervention, thereby enabling normal development of the visual system and learning process. In a masked investigation, 119 pre-school children enrolled in Project Headstart with a mean age of 3.51 years (range 3 to 5 years) had their vision screened using the Modified Clinical Technique (MCT). Monocular visual acuities in this population were determined using preferential-looking (PL) cards. Visual acuity assessment of young children in screening settings is at best a challenge; yet, all 119 children were able to complete monocular acuity assessments on each eye. Acuities for nonreferrals (individuals who passed the screening) were significantly better than for referrals (individuals who failed the screening) at the 0.0167 level using a two-tailed Fisher's Exact Test with the Bonferroni Method for multiple comparisons. The effectivity of the screening technique as determined by phi-coefficient remained highest (phi = +0.94) with the visual acuity referral criterion set at 6/12 (20/40) or less either eye and/or greater than or equal to a 2-octave difference between the eyes. The resultant referral rate (17.6%) was higher than that predicted by extrapolation from the Orinda Study for this age group (12.3%) but expected because of the different socioeconomic group. PL cards enabled monocular visual acuity measurement on 100% of the children tested and measurably increased the effectiveness of the screening procedure.