Page 94 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS

CHAPTER 5
In this paper, the effect of omission of population-based eye screening at age 6-9 months on the detection of amblyopia is reported, comparing two consecutive birth cohorts, with and without specific eye screening. Evaluation of the screening and referral process in this study will also comprise omission of eye screening at the age of 14-24 months and visual acuity testing with the Amsterdam Picture Chart at 36 months.
MATERIALS AND METHODS
Study Design
Our study was a prospective population-based consecutive birth cohort study.
Patient Population
Preverbal screening between 6 and 9 months was omitted in one of two birth cohorts (together approximately 11 000 children; 6.5% of the Dutch birth rate) born in the regions of two CHC organizations: Icare, serving the provinces of Drenthe, east Flevoland and mid Gelderland (87 CHC’s) and the Municipal Health Service of Amsterdam, serving, among other parts of Amsterdam, its northern district (3 CHC’s).
Screened group
Children born between July 1st and December 31st 2011 were eye screened according to national protocol with the VOV test which at 1-2 and 3-4 months comprises inspection of the eyes, pupillary reflexes, eye motility and red fundus reflex testing and at 6-9 months comprises inspection of the eyes, pupillary reflexes, eye motility, Hirschberg test, cover test and pursuit movements.
Unscreened group
Children born between January 1st and June 30th 2012 were only eye screened at 1-2 and 3-4 months. These children attended the general screening exams at 6-9 months, but specific eye screening was omitted. Preventive CHC physicians were instructed only to perform an eye exam in this group in case of observed eye problems (by either parent or physician) or positive family history.
Parents in this group were informed through an information leaflet and had the possibility to decline participation, and receive an eye examination at age 6-9 months.
The Medical Ethical Committee of the Erasmus Medical Center declared that the Medical Research Involving Human Subjects Act did not apply to this research
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