Kaymak Hakan, Neller Kai, Funk Saskia, Langenbucher Achim, Seitz Berthold, Schwahn Hartmut
Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland.
Internationale Innovative Ophthalmochirurgie, Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Deutschland.
Ophthalmologe. 2022 Jan;119(Suppl 1):25-32. doi: 10.1007/s00347-021-01394-5. Epub 2021 May 3.
We present a pilot project to improve eye health in schoolchildren: annual optometric screening with a focus on early detection of school myopia. The logistical proof-of-concept is illustrated by way of a pilot project at a state high school in North Rhine-Westphalia. The collected biometric parameters also contribute to the collection of epidemiological data.
On organized examination days objective and subjective refractions of schoolchildren in grades 5-7 (ages 9-16 years) were determined, children were tested for abnormalities in binocular vision and the photopic and mesopic pupil diameters were determined. Noncontact biometry was used to measure the corneal radius, central corneal thickness, anterior chamber depth, lens thickness and axial length of the eyes. Optical coherence tomography (OCT) was used to also determine the central choroidal thickness of the eyes. Questionnaires were employed to inquire about the visual habits of the schoolchildren.
In the fall of 2019 a total of 274 schoolchildren (11.2 ± 1.2 years) voluntarily participated in the examinations: 22% (61) showed myopia (spherical equivalent ≤ -0.50 D), of which 11% (7) were previously uncorrected (uncorrected distance visual acuity < 0.8). Of the schoolchildren 8% (5) showed an increase in myopia of more than -0.5 D compared to their actual spectacle values (distance visual acuity with ophthalmic lens < 0.8). A class of about 25 pupils can be examined within 2 regular periods.
There is an actual need for optometric screening because a total of 4.4% (12) myopic schoolchildren could be identified who had a distance visual acuity of less than 0.8 even with the correction. By determining the axial length and classifying this value depending on age in the literature can help to predict the individual risk of myopia and to raise awareness among parents and children to address this problem. The planned repetition of these examinations enables a better understanding of eye growth in schoolchildren.
我们提出了一个改善学童眼部健康的试点项目：每年进行验光筛查，重点是早期发现学校近视。通过北莱茵 - 威斯特法伦州一所国立高中的试点项目展示了后勤方面的概念验证。收集的生物特征参数也有助于流行病学数据的收集。
在组织好的检查日，确定5至7年级（9至16岁）学童的客观和主观屈光不正，检测儿童双眼视觉异常，并测定明视和中视瞳孔直径。使用非接触式生物测量法测量眼睛的角膜半径、中央角膜厚度、前房深度、晶状体厚度和眼轴长度。光学相干断层扫描（OCT）也用于确定眼睛的中央脉络膜厚度。采用问卷调查询问学童的视觉习惯。
2019年秋季，共有274名学童（11.2±1.2岁）自愿参加检查：22%（61名）表现为近视（等效球镜度≤ -0.50 D），其中11%（7名）之前未矫正（未矫正远视力<0.8）。8%（5名）的学童与实际眼镜度数相比近视增加超过 -0.5 D（戴眼镜远视力<0.8）。在两个常规时间段内可以检查大约25名学生的一个班级。
确实需要进行验光筛查，因为总共可以识别出4.4%（12名）即使矫正后远视力仍低于0.8的近视学童。通过测定眼轴长度并根据文献中的年龄对该值进行分类，有助于预测个体近视风险，并提高家长和儿童对解决这一问题的认识。计划重复这些检查能够更好地了解学童的眼睛发育情况。
