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Dimensional vision screening in preschool children: The Vision study.

R Adrar1, A Bourmaud2, D Benni2

  • 1Hôpital universitaire pédiatrique CHU Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Hôpitaux pédiatriques de Nice, Fondation Lenval, 57, avenue de la Californie, 06200 Nice, France.

Journal Francais D'Ophtalmologie
|December 18, 2025
PubMed
Summary

The French Association of Strabismology and Pediatric Ophthalmology (AFSOP) vision screening protocol is feasible and shows high sensitivity for detecting amblyopia in preschool children. Further research is needed to improve its specificity and reduce referral rates.

Keywords:
AFSOPAmblyopiaAmblyopieCOVID-19Dépistage visuelGuidelinesPediatricsPhotodépistagePhotoscreeningPédiatrieRecommandationsStrabismeStrabismusVision screening

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Area of Science:

  • Ophthalmology
  • Pediatric Health
  • Public Health

Background:

  • Amblyopia is a significant cause of childhood visual impairment.
  • France lacks a national vision screening program for children.
  • The French Association of Strabismology and Pediatric Ophthalmology (AFSOP) developed guidelines for preschool vision screening.

Purpose of the Study:

  • To assess the feasibility of the AFSOP vision screening protocol.
  • To evaluate the performance of the AFSOP protocol compared to the PARIS protocol.
  • To determine the sensitivity and specificity of the AFSOP protocol.

Main Methods:

  • Prospective, interventional, comparative feasibility study.
  • Cluster randomization comparing AFSOP protocol to PARIS school health service protocol.
  • Sensitivity measured against ophthalmologic examination with cycloplegia (gold standard).

Main Results:

  • Ninety-five preschool children participated (50 AFSOP, 45 PARIS).
  • AFSOP protocol demonstrated higher sensitivity (90%) compared to PARIS (62%).
  • The AFSOP protocol resulted in a 58% referral rate.

Conclusions:

  • The AFSOP 3D visual screening protocol is feasible and highly sensitive.
  • Specificity is a limitation, leading to a high referral rate.
  • Adjusting visual acuity thresholds may enhance specificity; larger studies are recommended.