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Evaluation of vision screening in five- to eight-year-old children living in Region Västra Götaland, Sweden - a prospective multicentre study.

Journal article
Authors Emelie Gyllencreutz
Anna Chouliara
Afsaneh Alibakhshi
Mathias Tjörnvik
Eva Aring
Marita Andersson Grönlund
Published in Acta ophthalmologica
Volume 97
Issue 2
Pages 158-164
ISSN 1755-3768
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 158-164
Language en
Subject categories Ophthalmology


To evaluate the current vision screening criteria regarding amblyopia and refractive errors, with emphasis on screening limits and retesting, in Region Västra Götaland (VGR), Sweden. Visual acuity (VA) screening is performed by nurses at primary healthcare centres (PHCs) in 4-year-old children and at school in 6- or 7-year-old children. Children with VA <0.65 (>0.19 logMAR) at either eye are referred. If VA is 0.65 in one or both eyes, a retest is performed by nurses at PHCs and schools, the children are then referred if VA is <0.8 (>0.10 logMAR).We included all children aged ≥5 and <8 years referred between October 2014 and June 2015 from PHCs and schools to the four eye clinics in VGR, with VA ≥0.65 in one or both eyes. At the eye clinic, children underwent assessment of VA, refraction in cycloplegia, eye motility, cover test, stereo test and a slit lamp examination.Among the 259/295 children (139 female) participating, median age was 5.7 years (5.0-7.8 years) at referral. Glasses were prescribed due to subnormal VA with refractive errors in 20% of the children, 22% displayed heterophoria, none had heterotropia and one younger child had amblyopia. Accurate retesting gave fewer false-positive referrals.Our results showed that a vision screening referral cut-off limit of VA <0.65 would leave undetected refractive errors. Residual amblyopia was uncommon. Accurate referral criteria, retesting and training of those performing the screening as well as re-evaluation of the screening programme are all important.

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Utskriftsdatum: 2019-11-12