Page 182 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS
P. 182

CHAPTER 9
IMPACT
As a result of our study the following changes have been made to the Dutch vision screening guideline:
- In the age category 0-3 months pupillary reflexes are no longer assessed
- In the age category 6-24 months only Hirschberg (corneal light reflex), cover test and monocular pursuit are assessed. Eye motility, pupillary reflexes and alternating cover test are no longer performed. More emphasis is placed on the anamnesis
- At the age of 36 months the VA measurement is only performed on indication. The APK is no longer used, but replaced by the Lea Hyvarinen chart
- At the age of 45-60 months VA measurement is performed with the Tumbling E chart instead of the Landolt C chart
FUTURE RESEARCH
The VA measurements at 36 months are now only performed on indication. Orthoptists in the Netherlands have indicated that in the former screening guideline half of their referrals were due to the screening with VA measurements at 36 months and the other half were due to the VA measurements at 45 months. In ongoing research we will further evaluate the VA measurements at 45 months at the CHC centres with emphasis on the depth of amblyopia, because it is possible that the VA measurements at 36 months would have detected more deep amblyopia earlier.
Screening programmes throughout Europe are also under further investigation in the EUSCREEN study, as well as the further development of the model for optimisation, disinvestment or implementation of vision screening.
180
























































































   180   181   182   183   184