Briscoe D, Lifshitz T, Grotman M, Kushelevsky A, Vardi H, Weizman S, Biedner B
Department of Ophthalmology, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheba, Israel.
Br J Ophthalmol. 1998 Apr;82(4):415-8. doi: 10.1136/bjo.82.4.415.
To test the effectiveness of a PC computer program for detecting vision disorders which could be used by non-trained personnel, and to determine the prevalence of visual impairment in a sample population of preschool children in the city of Beer-Sheba, Israel.
292 preschool children, aged 4-6 years, were examined in the kindergarten setting, using the computer system and "gold standard" tests. Visual acuity and stereopsis were tested and compared using Snellen type symbol charts and random dot stereograms respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and kappa test were evaluated. A computer pseudo Worth four dot test was also performed but could not be compared with the standard Worth four dot test owing to the inability of many children to count.
Agreement between computer and gold standard tests was 83% and 97.3% for visual acuity and stereopsis respectively. The sensitivity of the computer stereogram was only 50%, but it had a specificity of 98.9%, whereas the sensitivity and specificity of the visual acuity test were 81.5% and 83% respectively. The positive predictive value of both tests was about 63%. 27.7% of children tested had a visual acuity of 6/12 or less and stereopsis was absent in 28% using standard tests. Impairment of fusion was found in 5% of children using the computer pseudo Worth four dot test.
The computer program was found to be stimulating, rapid, and easy to perform. The wide availability of computers in schools and at home allow it to be used as an additional screening tool by non-trained personnel, such as teachers and parents, but it is not a replacement for standard testing.
测试一款可供非专业人员使用的用于检测视力障碍的个人电脑程序的有效性，并确定以色列贝尔谢巴市学龄前儿童样本群体中的视力损害患病率。
在幼儿园环境中，使用该计算机系统和“金标准”测试对292名4至6岁的学龄前儿童进行检查。分别使用斯内伦氏符号图表和随机点立体图测试并比较视力和立体视觉。评估了敏感性、特异性、阳性预测值、阴性预测值和kappa检验。还进行了计算机伪沃思四点测试，但由于许多儿童无法计数，无法与标准沃思四点测试进行比较。
计算机测试与金标准测试在视力和立体视觉方面的一致性分别为83%和97.3%。计算机立体图的敏感性仅为50%，但其特异性为98.9%，而视力测试的敏感性和特异性分别为81.5%和83%。两项测试的阳性预测值均约为63%。使用标准测试时，27.7%的受试儿童视力为6/12或更低，28%的儿童没有立体视觉。使用计算机伪沃思四点测试发现5%的儿童存在融合障碍。
发现该计算机程序具有刺激性、快速且易于操作。学校和家庭中计算机的广泛普及使其能够被教师和家长等非专业人员用作额外的筛查工具，但它不能替代标准测试。
