Page 30 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS

CHAPTER 2
RESULTS
In all 39 countries (including two separate regions, Flanders and Wallonia, in Belgium), representatives were found. Vision representatives were found in 36 countries, hearing representatives in 38, and public-health representatives in 23 (Table 1).
Vision
Information on vision screening programmes was obtained from 36 countries including two regions in Belgian regions. No information could be obtained from Albania, Macedonia, and Moldova. Thirty-five countries have a vision screening programme in place. In Belgium, Bulgaria, Estonia, France, Romania, Spain, and Switzerland this is a regional programme. In several countries with a national vision screening programme in place, regional differences in screening protocols exist.
Infant and preverbal screening tests
Infant screening (age 0-4 months) included inspection, fixation, red reflex testing, Hirschberg test, Bruckner test, Cover test, pupillary reflexes, and motility. Most countries perform a combination of two or more of these tests. In Bulgaria, Greece, and Poland no infant screening is performed. In Germany only eye inspection is performed. In Ireland, Montenegro, and Spain, eye inspection is combined with red reflex testing. In Cyprus, Italy, Lithuania, and Malta only red reflex testing is done. In Latvia this is combined with motility testing. Preverbal screening (age 6-30 months) includes the same tests. Preverbal screening is not performed in eight countries, but most countries combine two or more tests.
Visual acuity (VA) measurements
In all countries VA is tested, but the age of the first measurement varies from 3-7 years of age. In a third of countries VA is tested once, one third twice, and in one third more than twice. In most countries, VA measurements are repeated at an older age. In children aged four years and younger VA charts are most commonly picture charts and the Lea Hyvarinen chart, above age four, Tumbling E and Snellen are most often used.
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