Page 141 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS
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High rate of failed visual-acuity measurements with the Amsterdam Picture Chart in screening at the age of 36 months
First measurement
A flow chart of the results of the first measurement and repeated measurements is presented in Figure 3. In 5,663 (67.0%) of the 8,448 children measured VA was sufficient with the APK, in 1,312 (15.5%) insufficient. In 1,400 (16.6%), the measurement failed and in 73 children (0.9%), data were missing. Of the 1,312 children with an insufficient VA, 107 were directly referred to an orthoptist or ophthalmologist. The VA measurement was repeated in 776 children at the CHC’s. The VA measurement was not repeated, nor was the child referred, in the other 429 children, (i) because the VA that was insufficient according to the Dutch guideline was incorrectly rated as sufficient (188 children, many of these had VA 5/6 and 5/5/), (ii) the parents or physician decided to measure again at the next general screening exam at age 45 months according to notes in the records (29 children), or (iii) because they did not attend for unknown reason (212 children). Of the 1,400 children with a failed measurement, 35 were directly referred to an orthoptist or an ophthalmologist. The VA measurement was repeated in 902 children at the CHC’s. The VA measurement was not repeated, nor was the child referred, in the remaining 463 children because (i) the parents or physician decided to re-measure at the next general screening exam at age 45 months according to notes in the records (86 children) or because (ii) they did not attended for unknown reason (377 children).
Repeated VA measurement after insufficient first VA measurement
In 776 children with an insufficient VA measured the first time, the measurement was repeated, and in 234 of these the VA was insufficient, of which 35 children were not referred. In 43 children the second measurement failed, of which 17 children were not referred. Reasons for non-referral are listed in Figure 3.
Repeated VA measurement after failed first VA measurement
In 902 children with a failed measurement, the measurement was repeated, and in 152 of these, the VA was insufficient, of which 49 were not referred. In 216 children, the second measurement failed, of which 150 (69.4%) children were not referred. In at least half of these children, measurement of VA was deferred to the next general screening examination at 45 months. Reasons for non-referral are listed in Figure 3.
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