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A new computer program for mass screening of visual defects in preschool children
D Briscoe1, T Lifshitz, M Grotman
1Department of Ophthalmology, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheba, Israel.
Insights
A PC computer program effectively screens preschool children for vision disorders, showing high agreement with standard tests for stereopsis and visual acuity. This tool can aid non-trained personnel in early detection, though it complements rather than replaces professional eye exams.
Area of Science:
- Ophthalmology
- Pediatric Vision Screening
- Computer-Aided Diagnostics
Background:
- Vision disorders in preschool children can lead to long-term visual impairment.
- Early detection and intervention are crucial for effective treatment.
- Current screening methods may require trained personnel and specialized equipment.
Purpose of the Study:
- To evaluate a PC computer program for detecting vision disorders in preschool children.
- To determine the prevalence of visual impairment in a sample of preschool children in Beer-Sheba, Israel.
- To assess the program's usability by non-trained personnel.
Main Methods:
- 292 preschool children (aged 4-6) were tested using the computer program and standard "gold standard" tests.
- Visual acuity (Snellen charts) and stereopsis (random dot stereograms) were compared.
- Sensitivity, specificity, and predictive values were calculated.
Main Results:
- High agreement between computer and gold standard tests for visual acuity (83%) and stereopsis (97.3%).
- Computer stereogram sensitivity was 50% with 98.9% specificity; visual acuity test sensitivity was 81.5% with 83% specificity.
- Prevalence: 27.7% had visual acuity ≤6/12, 28% lacked stereopsis, and 5% had fusion impairment.
Conclusions:
- The computer program is engaging, quick, and user-friendly for non-trained personnel.
- It serves as a valuable supplementary screening tool for teachers and parents.
- The program does not replace comprehensive eye examinations by professionals.
Aims:
To test the effectiveness of a PC computer program for detecting vision disorders which could be used by non-trained personnel, and to determine the prevalence of visual impairment in a sample population of preschool children in the city of Beer-Sheba, Israel.
Methods:
292 preschool children, aged 4-6 years, were examined in the kindergarten setting, using the computer system and "gold standard" tests. Visual acuity and stereopsis were tested and compared using Snellen type symbol charts and random dot stereograms respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and kappa test were evaluated. A computer pseudo Worth four dot test was also performed but could not be compared with the standard Worth four dot test owing to the inability of many children to count.
Results:
Agreement between computer and gold standard tests was 83% and 97.3% for visual acuity and stereopsis respectively. The sensitivity of the computer stereogram was only 50%, but it had a specificity of 98.9%, whereas the sensitivity and specificity of the visual acuity test were 81.5% and 83% respectively. The positive predictive value of both tests was about 63%. 27.7% of children tested had a visual acuity of 6/12 or less and stereopsis was absent in 28% using standard tests. Impairment of fusion was found in 5% of children using the computer pseudo Worth four dot test.
Conclusions:
The computer program was found to be stimulating, rapid, and easy to perform. The wide availability of computers in schools and at home allow it to be used as an additional screening tool by non-trained personnel, such as teachers and parents, but it is not a replacement for standard testing.