Ninewells Hospital Tayside, Dundee, UK.
City, University of London, London, UK.
Eye (Lond). 2024 Jul;38(10):1941-1946. doi: 10.1038/s41433-024-03047-8. Epub 2024 Apr 10.
BACKGROUND/OBJECTIVES: The See4School programme in Scotland is a pre-school vision screening initiative delivered by orthoptists on a national scale. The primary objective of any vision screening programme is to identify amblyopia, given the common understanding that this condition is unlikely to be detected either at home or through conventional healthcare channels. The target condition is not bilateral visual impairment, as it is believed that most children will be identified within the first year of life either through observations at home or as part of the diagnosis of another related disorder. This belief persists even though bilateral visual impairment is likely to have a more detrimental impact on a child's day-to-day life, including their education. If this hypothesis were accurate, the occurrence of bilateral visual impairment detected through the Scottish vision screening programme would be minimal as children already under the hospital eye service are not invited for testing. The overarching aim of this study was therefore to determine the prevalence of presenting bilateral visual impairment associated with refractive error detected via the Scottish preschool screening programme.
SUBJECTS/METHODS: Retrospective anonymised data from vision screening referrals in Scotland from 2013-2016 were collected. Children underwent an assessment using a crowded logMAR vision test and a small number of orthoptic tests.
During the 3-year period, out of 165,489 eligible children, 141,237 (85.35%) received the vision screening assessment. Among them, 27,010 (19.12%) failed at least one part of the screening and were subsequently referred into the diagnostic pathway, where they received a full sight test. The prevalence of bilateral visual impairment associated with refractive error and detected via the vision screening programme (≥ 0.3LogMAR) was reported to range between 1.47% (1.37-1.59) and 2.42% (2.29-2.57).
It is estimated that up to 2.42% (2.29-2.57) of children living Scotland have poorer than driving standard of vision (6/12) in their pre-school year, primarily due to undetected refractive error. Reduced vision has the potential to impact a child's their day-to-day life including their future educational, health and social outcomes.
背景/目的：苏格兰的 See4School 计划是一项由视轴矫正专家在全国范围内开展的学前视力筛查计划。任何视力筛查计划的主要目的都是发现弱视，因为普遍认为这种情况在家中或通过常规医疗保健渠道都不太可能被发现。目标病症不是双眼视力障碍，因为人们相信，大多数儿童会在生命的第一年通过在家中的观察或作为其他相关疾病诊断的一部分被发现。尽管双眼视力障碍更有可能对儿童的日常生活，包括他们的教育，产生更不利的影响，但这种信念仍然存在。如果这一假设是准确的，那么通过苏格兰视力筛查计划发现的双眼视力障碍的发生率应该很低，因为已经在医院眼科服务下的儿童不被邀请进行测试。因此，这项研究的总体目标是确定通过苏格兰学前筛查计划发现的与屈光不正相关的双眼视力障碍的患病率。
研究对象/方法：收集了 2013-2016 年苏格兰视力筛查转诊的回顾性匿名数据。儿童接受了拥挤 logMAR 视力测试和少数视轴矫正测试。
在 3 年期间，在 165489 名符合条件的儿童中，有 141237 名（85.35%）接受了视力筛查评估。其中，27010 名（19.12%）至少有一部分筛查失败，随后被转诊到诊断途径，在那里他们接受了全面的视力检查。通过视力筛查计划（≥0.3LogMAR）发现的与屈光不正相关的双眼视力障碍的患病率报告在 1.47%（1.37-1.59）和 2.42%（2.29-2.57）之间。
据估计，苏格兰有多达 2.42%（2.29-2.57）的学龄前儿童的视力低于驾驶标准（6/12），主要是由于未被发现的屈光不正。视力下降有可能影响儿童的日常生活，包括他们未来的教育、健康和社会成果。
