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[Visual acuity in German preschool children-results of a cross-sectional study]
Heike M Elflein1, Roman Pokora2,3, Denis Müller4
1Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland. heike.elflein@unimedizin-mainz.de.
Insights
Pediatric screening examinations U8 and U9 in Germany are linked to better visual acuity results at school entry. Participation in these early screenings improves the chances of good vision outcomes for children.
Area of Science:
- Pediatric ophthalmology
- Public health screening programs
- Childhood vision assessment
Background:
- Germany lacks a specific ophthalmological screening examination for children.
- Pediatric screening examinations (U8 and U9) include general visual function checks.
- This study examines the link between these screenings and later vision outcomes.
Purpose of the Study:
- To determine if participation in pediatric screening examinations U8 and U9 is associated with visual acuity results at school entry examinations (SEU).
Main Methods:
- Evaluated SEU data from Rhineland-Palatinate (2009/2010-2014/2015).
- Visual acuity was measured using the Rodenstock visual testing device (E-hooks).
- Multiple logistic regression analyzed the association between U8/U9 participation and visual acuity <0.7, adjusting for confounders.
Main Results:
- Included data from 189,704 children; 4.4% had visual acuity <0.7.
- Participation rates for U8 and U9 were high (93.9% and 93.3%).
- U8 and U9 participation showed a significant negative association with unilateral/bilateral visual acuity <0.7 (ORs 0.68 and 0.57, respectively).
Conclusions:
- A notable proportion of children exhibited reduced visual acuity at school entry.
- Participation in U8 and U9 pediatric screenings is associated with improved visual acuity outcomes at school entry.
Background:
Within the framework of the German pediatric screening examinations, the checks include visual functions. There is no ophthalmological screening examination in childhood in Germany. This study investigated whether participation in the pediatric screening examinations U8 (at the end of the fourth year of life) and U9 (at the beginning of the sixth year of life) is associated with the results of visual acuity, which are compiled at the school entry examinations (SEU).
Methods:
This study evaluated data of the SEU for school the enrollment years 2009/2010-2014/2015 of the State of Rhineland-Palatinate. In these years visual acuity was assessed using the Rodenstock visual testing device (E-hooks; Rodenstock intruments GmbH, Ottobrunn, Deutschland) wearing glasses if present. The association between participation in the U8 and U9 screening examinations and the presence of unilateral and bilateral visual acuity <0.7 was investigated using multiple logistic regression adjusted for important disturbance variables.
Results:
Data from 189,704 children (91,041 girls, 98,663 boys) from 35 out of 36 districts were included. A visual acuity <0.7 was measured in 8416 (4.4%) children and in both eyes in 4345 (2.3%) children. The participation rates in the U8 and U9 were 93.9% and 93.3%, respectively. There was a negative association between participation in the U8 and U9 and a unilateral or bilateral SEU visual acuity <0.7 (adjusted odds ratio, OR 0.68, 95% confidence interval, CI 0.61-0.75; p < 0.01, N = 124,467/adjusted OR 0.57, 95% CI 0.51-0.65; p < 0.01, N = 121,496).
Conclusion:
The proportion of children with visual acuity <0.7 at the SEU was high. Children who were examined in the U8 and U9 had a better chance for a good visual acuity in the school entry examination.
