Benefits of consulting a certified orthoptist in a pediatric vision screening program

In Japan, all 3-year-old children undergo a three-step municipal vision screening that includes home-based screening, secondary screening at a health center, and comprehensive ophthalmologic examination, if warranted. We investigated whether screening by a certified orthoptist (CO) could improve the detection of visual dysfunctions, including amblyopia. Three-year-olds in Nobeoka City were invited to undergo primary and secondary screenings from April 2008 to March 2011. COs performed the secondary screening tests; children with a positive secondary screening received a comprehensive ophthalmologic examination. Of the 3,303 eligible children, 98 were positive on detailed examination. Of these, 25% were classified as false-negatives. Eight children with amblyopia in the false-negative group accounted for 24% of all 33 amblyopia cases detected on detailed examination.