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Updated: Sep 19, 2026
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Effectiveness of a Preschool Vision Screening Program for Early Detection of Refractive Errors: Evidence From a
Shakhnoza T Iskandarova1, Malika M Miralimova1, Nodira R Yangieva2
1Department of Public Health and Health Care Management No. 2, Tashkent State Medical University, Tashkent, Uzbekistan.
Introduction:
Evidence on the real-world performance of preschool vision screening remains limited in middle-income settings. This study evaluated a preschool-based vision screening program in Tashkent, focusing on coverage, diagnostic yield, referral completion, and selected contextual factors.
Methods:
A prospective evaluation was conducted from January 2025 to January 2026 in 24 state preschools across all 12 districts of Tashkent. Children aged 5-7 years underwent monocular visual acuity testing and noncycloplegic autorefraction. Screening outcomes were based on visual acuity in the worse eye; children with borderline (Vis=0.8-0.9) or reduced (Vis<0.8) visual acuity were classified as screen positive and referred for an ophthalmologic examination. Refractive assessment followed standard international definitions. Confirmatory examinations included objective refraction, with cycloplegic refraction used to confirm refractive error. Parental questionnaires and classroom illumination were analyzed descriptively.
Results:
Among 1,284 screened children (mean age of 6.39±0.58 years), 25.9% were screen positive, and 90.4% completed referral. Confirmed refractive errors were identified in 13.7%, most commonly hyperopia (38.6%). Limited prior eye care was observed despite generally positive parental attitudes, and most classrooms had suboptimal illumination.
Conclusions:
Preschool vision screening was feasible and yielded substantial case detection under routine urban conditions, supporting its integration into preschool health services.
