Findlay Rebecca W, Goodman Lucy K, Anstice Nicola S, Chelimo Carol, Grant Cameron C, Black Joanna M
School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, Australia.
Clin Exp Optom. 2024 Oct 7:1-6. doi: 10.1080/08164622.2024.2410036.
Vision screening is important for detecting undiagnosed vision conditions that are common in school-aged children. However, current vision screening protocols are poor at detecting vision conditions that are most common in the Aotearoa New Zealand paediatric population.
Uncorrected refractive error and amblyopia are the most common causes of visual impairment in children. The most appropriate vision screening method depends on the refractive error profile of the population. This study aimed to: estimate the prevalence of refractive errors and amblyopia risk factors among children living in Aotearoa New Zealand; describe previous participation in preschool vision screening and determine the diagnostic accuracy of potential screening methods.
Children aged 7-10 years received comprehensive eye examinations, including cycloplegic refraction, in their school. Eye examination results were assessed for refractive error and amblyopia risk factors. The sensitivity and specificity of individual vision tests for detecting any vision conditions was calculated to assess the most effective tests for vision screening.
Eye examinations were completed for 237 children and cycloplegic refraction data was available for 220 of these children. Significant refractive error (need for glasses) was detected in 23.6% of children (7.7% myopia, 7.7% hyperopia, 15.0% astigmatism). Amblyopia risk factors were detected in 9.1% of children. Preschool vision screening had been completed by 78.5% of children. Distance visual acuity screening alone had a sensitivity of 39% for detecting vision conditions, with addition of the Spot Vision Screener improving sensitivity to 65%.
Astigmatism is the most frequent refractive error among children aged 7-10 years living in Aotearoa New Zealand. Distance visual acuity screening alone is ineffective in detecting refractive error in children in Aotearoa New Zealand. Further research investigating refractive errors across the paediatric population in Aotearoa New Zealand is required to determine the optimal timing and appropriate protocols for school-aged vision screening.
视力筛查对于检测学龄儿童中常见的未诊断视力状况很重要。然而，当前的视力筛查方案在检测新西兰奥塔哥地区儿科人群中最常见的视力状况方面效果不佳。
未矫正的屈光不正和弱视是儿童视力损害的最常见原因。最合适的视力筛查方法取决于人群的屈光不正情况。本研究旨在：估计新西兰奥塔哥地区儿童屈光不正和弱视危险因素的患病率；描述先前参与学前视力筛查的情况，并确定潜在筛查方法的诊断准确性。
7至10岁的儿童在学校接受了包括睫状肌麻痹验光在内的全面眼科检查。对眼科检查结果进行屈光不正和弱视危险因素评估。计算个体视力测试检测任何视力状况的敏感性和特异性，以评估最有效的视力筛查测试。
对237名儿童完成了眼科检查，其中220名儿童有睫状肌麻痹验光数据。23.6%的儿童检测出有显著屈光不正（需要配镜）（7.7%近视、7.7%远视、15.0%散光）。9.1%的儿童检测出有弱视危险因素。78.5%的儿童完成了学前视力筛查。仅远距离视力筛查检测视力状况的敏感性为39%，加上使用视力筛查仪后敏感性提高到65%。
在新西兰奥塔哥地区居住的7至10岁儿童中，散光最常见。仅远距离视力筛查在检测新西兰奥塔哥地区儿童屈光不正方面效果不佳。需要进一步研究新西兰奥塔哥地区儿科人群的屈光不正情况，以确定学龄儿童视力筛查的最佳时机和合适方案。
