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Practical community photoscreening in very young children
Susannah Q Longmuir1, Erin A Boese, Wanda Pfeifer
1Department of Ophthalmology, University of Iowa, Iowa City, IA 52246, USA. susannah-longmuir@uiowa.edu
Insights
Vision screening for children under 3 years old using photoscreening is reliable and effective. Early detection of amblyogenic risk factors in young children can be achieved through this method.
Area of Science:
- Ophthalmology
- Pediatrics
- Preventive Medicine
Background:
- US Preventive Services Task Force found insufficient data for vision screening in children younger than 3 years.
- The Iowa KidSight program has screened children aged 6 months and older since 2000.
- This study evaluates vision screening in children younger than 3 years using photoscreening.
Purpose of the Study:
- To compare the effectiveness of photoscreening in children younger than 3 years with older children.
- To determine the reliability of photoscreening for detecting amblyogenic risk factors in very young children.
- To recommend an age for initiating photoscreening based on study findings.
Main Methods:
- Retrospective review of the Iowa KidSight database.
- Analysis of photoscreening results from May 2000 to April 2011.
- Comparison of screening outcomes between children <3 years and children aged 3-6 years.
Main Results:
- Over 210,000 photoscreens were analyzed.
- In children <3 years: unreadable rate 13.0%, referral rate 3.3%, positive-predictive value 86.6%.
- In children 3-6 years: unreadable rate 4.1%, referral rate 4.7%, positive-predictive value 89.4%.
Conclusions:
- No statistically significant difference in screening outcomes between children aged 1-3 years and older children.
- Photoscreening reliably detects amblyogenic risk factors in children younger than 3 years.
- Recommends initiating photoscreening in children aged 1 year and older.
Objective:
Recent US Preventive Services Task Force recommendations on vision screening reported insufficient data to recommend vision screening in children <3 years of age. The Iowa photoscreening program, KidSight, has screened children from 6 months of age and older since 2000. We report our experience with vision screening in these children and compare the results of the photoscreens in children younger than 3 years with those of children of preschool age and older.
Methods:
A retrospective review of results from the Iowa KidSight database using the MTI PhotoScreener containing results of children screened between May 1, 2000, and April 30, 2011.
Results:
During the 11 years of the study, 210 695 photoscreens on children were performed at 13 750 sites. In the <3-year age group, the unreadable rate was 13.0%, the referral rate was 3.3%, and the overall positive-predictive value was 86.6%. In the 3- to 6-year-old children, the unreadable rate was 4.1%, the referral rate was 4.7%, and the overall positive-predictive value was 89.4%.
Conclusions:
No statistically significant difference was found in screening children from 1 to 3 years old compared with screening children >3 years old. These results confirm that early screening, before amblyopia is more pronounced, can reliably detect amblyogenic risk factors in children younger than 3 years of age, and we recommend initiation of photoscreening in children aged 1 year and older.
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