Abstract
Purpose: The effectiveness of preverbal orthoptic tests at age 6, 9, 14 and 24 months in population-wide screening was assessed. Methods: Two consecutive birth cohorts at 134 centres were compared. At general health screening visits, children born July–December 2011 were vision screened four times between 6 and 24 months with inspection, pupillary reflexes, eye motility, Hirschberg, cover test and monocular pursuit. Children born January–June 2012 were vision screened at general screening visits only in case of visually apparent abnormalities or positive family history. After referral, cause and severity of amblyopia were determined. Visual acuity was measured in all children at 36 and 45 months. Results: The control and intervention group comprised 5649 versus 5162 children. Amblyopia was diagnosed in 185 (3.3%) versus 159 children (3.1%), outside of screening in 21 (11.4%) versus 25 (15.7%). Between 6 and 24 months, 44 (23.8%) versus 27 (17%) (RR = 0.67 [95% CI 0.42, 1.09]) were referred and after visual acuity (VA) measurement 120 (64.9%) versus 107 (67.3%). Of 109 versus 108 children with refractive or bilateral amblyopia, 94 (86.2%) versus 92 (85.2%) were detected with VA measurements. Visual acuity of the amblyopic eye, after referral, was not significantly different between groups (p 0.896), nor was the time to amblyopia diagnosis (intention to screen [p 0.55]; per protocol [p 0.11]). Conclusion: The effectiveness of vision screening was not influenced by omission of orthoptic tests at general health screening at 6–24 months. Refractive and bilateral amblyopia were almost exclusively found by VA measurements.
| Original language | English |
|---|---|
| Pages (from-to) | e100-e114 |
| Number of pages | 15 |
| Journal | Acta Ophthalmologica |
| Volume | 100 |
| Issue number | 1 |
| Early online date | 4 Apr 2021 |
| DOIs | |
| Publication status | Published - Feb 2022 |
Bibliographical note
Funding Information:The authors thank all preventive CHC physicians from ICARE and the Municipal Health Service (GGD) Drenthe and our orthoptic research group consisting of the following orthoptists: Angelie Kroon, Karin Visser, Anneke Schoonenberg, Wilma van den Berg, Gerdien Verheij, Linda Lokhorst and Esmeralda Visser (St. Jansdal ziekenhuis Harderwijk), Xanne Slot, Japke van Dijk and Cindy Scholten (Gelderse Vallei Ede & Bergman Clinics Ede), Christine Bos‐Koelewijn, Marijke de Graaf‐Helfensteijn, Carina Wijkmans, Nilofar Sultanali, Jorien Schouten and Linda Boon (Oogziekenhuis Zonnestraal Lelystad/Emmeloord), Alice de Graaf and Mirjam Peeters (Oogziekenhuis Zonnestraal Amersfoort), Inge van Aggelen and Imke Westra‐Postma (Wilhelmina Ziekenhuis Assen), Jacqueline Bos and Hanneke Evers (Bethesda Ziekenhuis Hoogeveen), Annemiek Bennen, Marijke Hoekstra, Wijnanda Asjes and Elfi Dijkers (Isala Meppel), Ruth Boer and Tamara Alteveer (Saxenburgh Coevorden), Dina Schram‐Rienstra (Antonius Ziekenhuis Emmeloord), Jolanda Timmer‐de Kok, Tineke Hoolsema‐Greving and Friedel van Ketwich‐Godfroy (Treant Zorggroep Emmen/Stadskanaal), Liesbeth Steenbergen (Röpcke‐Zwiers Ziekenhuis Hardenberg), Mari Gutter (Isala Zwolle), Josine Arentzen, Marike Heuveling‐Rijswijk, Heleen van Andel, Marieke van Dijk, Elsa Lieverse, Marijke de Jongh‐van den Tweel and Jolanda de Vries (Meander Medisch Centrum Amersfoort/Baarn). The authors also like to thank Tim Holweg (Topicus) and Erik de Vries (Icare) for their help with the data collection. This study was financed by Stichting Lijf en Leven. This study sponsor had no role in the study design or in the collection, analysis and interpretation of the data nor in the writing of the report or in the decision to submit the paper for publication.
Publisher Copyright:
© 2021 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation