Screening criteria set for Swedish pre-school children needs to change

A Swedish initiative for screening the vision of six-years olds has found that those with a visual acuity (VA) of 0.65 rarely have defects that require treatment, making the current criterion of 0.8 too demanding on the available resources, according to a report published in the June issue of Acta Ophthalmologica Scandinavia.

Anna-Lena Hård from the Institute of Neuroscience and Physiology at Gothenburg University, Gothenburg, Sweden evaluated the new vision screening methods with particular attention to screening criteria. The current requirements state that, pre-school children with a VA <0.8 or symptoms, should be referred to eye clinics for VA testing, cover testing, cycloplegic autorefraction and ophthalmoscopy. The current screening limit of 0.8 was evaluated in relation to a limit of 0.65.

A total of 3,885 pupils underwent screening. Of these, 225 (6.6%) were referred and 236 underwent ophthalmological examination. Seventy-five percent of these were children with a VA of 0.65 in the worse eye and more than half of these were found, by the clinic, to have a VA of ≥0.8. Only 6.7% were found to have significant ammetropia.

Hård concluded that the current screening and referral criterion of 0.8 is too high, since most children with a VA of 0.65 rarely have defects requiring treatment.