Page 115 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS

Effectiveness of routine population-wide orthoptic preschool vision screening tests at age 6-24 months in The Netherlands
Figure 2. Number of orthoptic vision screenings performed between 6-24 months.
The national protocol in the control group indicated 2-4 orthoptic vision screenings during these moments. In the intervention group all the children were invited for general screening, but the vision screening was performed on indication only.
Referral
After screening at 6-24 months in the control group, 173 out of 5560 (3.1%) children were referred, versus 123 out of 5062 (2.4%) children in the intervention group (Relative Risk (RR) = 0.78 [95%CI 0.62, 0.98]). Observation of strabismus by either parents or screening physician was the referral reason, in 80 (46.2%) versus 57 (46.3%) children. A visually apparent problem as nystagmus, microphthalmos, ptosis, dacryostenosis, cyst, anisocoria was the reason for referral in 11 (6.4%) versus 22 (17.9%) children. The preverbal screening test itself, at 6-24 months, as primary screening instrument, led to a referral in 28 (16.2%) versus eight (6.5%) children. Whether the strabismus was detected by observation only, or by the screening test, could not be determined in 43 (24.9%) versus 32 (26.0%) children. Four children in both groups were referred due to positive family history (2.3% vs. 3.3%) and seven children in the control group for other causes (4.0%).
Visual acuity measurements at 36 months led to 258 (4.6%) versus 267 (5.3%) referrals. Visual acuity measurement at 45 months led to 308 (5.5%) versus 350 (6.9%) children were referred. Extra VA measurements at 60 months led to another 32 (0.6%) versus 15 (0.3%) referrals.
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