Vision screening in junior schools

doi:10.1016/S0033-3506(96)80010-2

Public Health

Volume 110, Issue 6, November 1996, Pages 369-372

https://doi.org/10.1016/S0033-3506(96)80010-2 Get rights and content

A prospective study of routine school vision tests in 1809 children aged 8 and 10 y was undertaken in schools in the Cambridge Health District over two years (1988–1990)_to establish whether a significant number of new defects of vision were detected. Although the visual acuity of 31% of children who had an abnormal test was recorded as abnormal, most abnormalities were minimal. Only 15 (0.83%) had newly diagnosed problems requiring treatment. Almost all children with marked visual abnormalities had already been detected before school entry, at the 5 y school vision test or on another occasion. Near vision testing did not identify any previously undiagnosed child with significant defects who did not also have distant vision abnormalities. Satisfactory colour vision test results had been recorded for most children at the 5 y school entry vision test. These data do not justify the continued use of routine vision screening in junior schools.

References (14)

Royal College of Ophthalmologists
Ophthalmic Services for Children
(1994)
HallDMB
WilsonJ
Health services for children in the community
BMJ
(1993)
JewellG et al.
The effectiveness of vision screening by school nurses in secondary school
Arch Dis Child
(1994)
PeckhamCS et al.
Acquired myopia in 11 year old children
BMJ
(1977)
Stewart-BrownS et al.
Educational attainments of children with treated and untreated visual defects
Dev Med Child Neurol
(1985)

There are more references available in the full text version of this article.

Cited by (30)

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To study associations between strabismus and alcohol use, anxiety, and depression among 10- to 17-year-old children in Guangdong, southern China.
Cross-sectional, population-based study.
Among 7537 children aged 6-17 years from 9 randomly selected primary and middle schools, ocular alignment was assessed with the Hirschberg light reflex, cover-uncover testing, and alternate cover testing at distance (6 m) and near (40 cm). Additionally, 4000 children (53.1%) aged 10+ years received self-administered questionnaires containing screening questions on alcohol use, anxiety, and depression.
Examinations were completed on 7464 of 7537 subjects (99.0%), including 3928 boys (52.6%), with a mean age of 11.1 ± 1.8 years. The prevalence of any strabismus, including exotropia (2.7%), esotropia (0.2%), and intermittent exotropia (3.9%), was 6.8%. Strabismus was more prevalent in urban students (7.3%) and female subjects (7.4%) compared to rural students (6.0%) and male subjects (6.2%) (all P < .05). In multivariate regression models, any strabismus was associated with older age and rural vs urban residence. Among 3903 children (97.6%) answering questionnaires, history of alcohol use (62.3% vs 36.3%) and positive screening responses for depression (26.0% vs 11.6%) and anxiety (10.3% vs 4.9%) were significantly (P < .01 for all) more common among children with strabismus.
These Chinese children with strabismus had a significantly higher prevalence of alcohol use and possible markers of emotional problems than children without strabismus. Further research should focus on the appropriateness of classifying surgical treatment for strabismus as “cosmetic” (ineligible for reimbursement) under China's rural health insurance.
The possible association of attention deficit hyperactivity disorder with undiagnosed refractive errors
2013, Journal of AAPOS
Citation Excerpt :
Most of these studies, however, are problematic because they were not performed under cycloplegia, unlike the present study. In contrast to the myopic child, the hypermetropic child may go undiagnosed.24-31 Hypermetropic children, compared with emmetropic children, have good visual acuity for far objects but must make an extra accommodative effort to see near objects.
To evaluate whether attention deficit disorder (ADD) or attention deficit with hyperactivity disorder (ADHD) is associated with undiagnosed refractive errors or binocular function difficulties.
In this case–control study, ADD/ADHD children diagnosed according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR), along with age-matched controls, were examined at the ADD clinic at the Sheba Medical Center. For children in both groups the following data were recorded: uncorrected visual acuity for distance and near, cycloplegic refraction, ocular motility, and binocular function.
A total of 56 children (12 girls; mean subject age, 9.5 years) were included in the ADD/ADHD group. The control group comprised 66 patients (29 girls; mean subject age, 9 years). Mean uncorrected visual acuity was nearly 20/20 for distance and J1 for near in both groups. Cycloplegic spherical equivalent was +0.89 ± 1.1 D for the control group and +0.63 ± 0.89 D for the ADD/ADHD group (P = 0.16). Binocular function and accommodation were similar in both groups, except for a significant difference between the near point of convergence of the controls versus the ADD/ADHD group (5.3 ± 2.3 cm versus 4.1 ± 1.8 cm, respectively; P = 0.002).
ADD/ADHD children had similar visual acuity at distance and near and refractive errors as normal subjects. Binocular function and accommodation were also found to be similar in both groups and thus might not contribute to ADD/ADHD.
The Development of Myopia Among Children With Intermittent Exotropia
2010, American Journal of Ophthalmology
To describe the long-term refractive error changes in children diagnosed with intermittent exotropia (IXT) in a defined population.
Retrospective, population-based observational study.
Using the resources of the Rochester Epidemiology Project, the medical records of all children (<19 years) diagnosed with IXT as residents of Olmsted County, Minnesota, from January 1, 1975 through December 31, 1994 were retrospectively reviewed for any change in refractive error over time.
One hundred eighty-four children were diagnosed with IXT during the 20-year study period; 135 (73.4%) had 2 or more refractions separated by a mean of 10 years (range, 1–27 years). The Kaplan-Meier rate of developing myopia in this population was 7.4% by 5 years of age, 46.5% by 10 years, and 91.1% by 20 years. There were 106 patients with 2 or more refractions separated by at least 1 year through 21 years of age, of which 43 underwent surgery and 63 were observed. The annual overall progression was −0.26 diopters (SD ± 0.24) without a statistically significant difference between the observed and surgical groups (P = .59).
In this population-based study of children with intermittent exotropia, myopia was calculated to occur in more than 90% of patients by 20 years of age. Observation versus surgical correction did not alter the refractive outcome.
Refractive error study in children: Sampling and measurement methods for a multi-country survey
2000, American Journal of Ophthalmology
PURPOSE:
The Refractive Error Study in Children was designed to assess the prevalence of refractive error and vision impairment in children of different ethnic origins and cultural settings.
METHODS:
Population-based cross-sectional samples of children 5 to 15 years of age were obtained through cluster sampling. Presenting, uncorrected, and best-corrected visual acuity, along with refractive error under cycloplegia, were the main outcome measures. Amblyopia and other causes of uncorrectable vision impairment were determined.
RESULTS:
Study design and sample size calculations, survey enumeration and ophthalmic examination methods, quality assurance monitoring, and data analyses and statistical methods are described.
CONCLUSIONS:
The study design, sample size, and measurement methods ensure that the prevalence of age-specific and sex-specific refractive error can be estimated with reasonable accuracy in the target populations. With commonality of methods, a comparison of findings between studies in different ethic origins and cultural settings is possible.
Colour blindness
1998, Public Health
The physiology of colour vision is discussed; as is the way in which the human eye can detect various combinations of red, green and blue. Red-green colour blindness, with X-linked inheritance, is the most common, but other types are also considered. Methods of testing relating to the age of the child are reviewed.
The use of colours in teaching is widespread, but there is controversy over the difficulties this may cause a colour blind child. A review of the literature does not reveal much information on this, and any problems that do arise are likely to be individual to the child, and to depend on such factors as overall intelligence, the attitude of the teacher, and the personality of the child.
There is no doubt that it is essential to recognise colour vision defects when it comes to choosing a career, and that tests must be done during secondary schooling, but in order to avoid some affected children being disadvantaged there is enough evidence to support testing at school entry.
Early Detection of Refractive Errors by Photorefraction at School Age
2022, International Journal of Environmental Research and Public Health

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View full text

Vision screening in junior schools

Ophthalmic Services for Children

Health services for children in the community

BMJ

The effectiveness of vision screening by school nurses in secondary school

Arch Dis Child

Acquired myopia in 11 year old children

BMJ

Educational attainments of children with treated and untreated visual defects

Dev Med Child Neurol