Swanson M W
University of Alabama at Birmingham 35294-0010.
J Am Optom Assoc. 1994 Aug;65(8):581-3.
The purpose of this study was to determine how a variety of reasonable vision screening criteria affected the results of vision screening previously performed on a community-dwelling older adult population.
The records of 201 previously performed vision screening evaluations of adults over the age of 65 were reanalyzed to determine failure rates using new theoretical criteria. Those criteria included screening by history alone, visual acuity alone, history in combination with visual acuity and a multiple test format with both 20/40 and 20/60 acuity criteria.
Theoretical screening that would have taken place using visual acuity of less than 20/60 failed the fewest individuals; however, even using this minimal criteria 46 percent of those screened would have failed. Using a multiple test format the failure rate rises to almost 90 percent. The combination of historical criteria and visual acuity failed almost an identical population as would be failed by using an elaborate multiple test format.
The prevalence of ocular abnormalities in this older adult populations was so high that vision screening done with even minimal criteria can be expected to fail very high numbers. Similar failure rates and composition can be achieved by using historical criteria in combination with visual acuity as are achieved using a more elaborate multiple-test format. Given the high prevalence of eye abnormalities in the older adult population the public health value of screening for the need for eye examination is questionable.
本研究的目的是确定各种合理的视力筛查标准如何影响先前对社区居住的老年人群进行的视力筛查结果。
重新分析了201份先前对65岁以上成年人进行的视力筛查评估记录，以使用新的理论标准确定失败率。这些标准包括仅通过病史筛查、仅通过视力筛查、病史与视力相结合以及采用20/40和20/60视力标准的多重测试形式。
使用低于20/60的视力进行理论筛查时，失败的个体最少；然而，即使使用这一最低标准，仍有46%的受筛查者会失败。采用多重测试形式时，失败率上升至近90%。病史标准与视力相结合时，失败的人群与采用复杂的多重测试形式时几乎相同。
该老年人群中眼部异常的患病率如此之高，以至于即使采用最低标准进行视力筛查，预计失败人数也会非常多。通过将病史标准与视力相结合，可以实现与采用更复杂的多重测试形式相似的失败率和构成情况。鉴于老年人群中眼部异常的高患病率，筛查是否需要进行眼部检查的公共卫生价值值得怀疑。
