Is refraction with a hand-held autorefractometer useful in addition to visual acuity testing and questionnaires in preschool vision screening at 3.5 years in Japan?
Is refraction with a hand-held autorefractometer useful in addition to visual acuity testing and questionnaires in preschool vision screening at 3.5 years in Japan?
复制标题
在日本，除了视力测试和学龄前 3.5 岁视力筛查问卷调查之外，使用手持式自动验光仪进行验光是否有用？
作者：
T. Matsuo;C. Matsuo;K. Kio;N. Ichiba;H. Matsuoka
日本针对3.5岁儿童的视力筛查计划包括3个步骤：问卷调查和家庭视力测试，护士视力测试和地区公共卫生中心医务人员的检查，以及眼科医生的检查。在这项研究中，除了视力测试和检查外，我们还使用手持式自动验光仪测试屈光度，以揭示自动屈光是否能更好地检测眼睛问题。由一名检查员对265名3.5岁的儿童进行了连续6次的自动屈光检查，这些儿童都去过同一个中心。这些儿童被送到眼科医生根据屈光不正标准进行的第三步检查：3个屈光度近视或1个屈光度远视，和/或两只眼的屈光度散光，除了目前的标准：1)中心视力为0.5的双眼不合格，2)问卷显示的与眼睛相关的症状，或3)医务人员发现的眼睛问题。为儿童(24%)发出了去看眼科医生的通知，其中37人(58%)进行了就诊，从而将包含最终诊断的文件发回了公共卫生办公室。在儿童中，12名儿童仅根据现行标准被送往眼科医生，10名儿童同时根据当前标准和屈光不正标准，42名儿童仅根据屈光不正标准。根据目前的标准，在去看眼科医生的13名儿童中，有12名被诊断为弱视和斜视。相比之下，仅按屈光不正标准去看眼科医生的24名儿童中，有15名主要诊断为屈光不正，没有严重问题。总而言之，除了视力测试和检查外，自动验光只在3.5年后发现了一例额外的眼病，同时将儿童送往眼科医生进行第三步检查的人数增加了两倍。因此，从成本效益的角度来看，当当前系统按设计进行时，不建议将自动屈光作为额外的测试。
The vision-screening program for 3.5-year-old children in Japan consists of 3 steps:questionnaires and home visual acuity testing, visual acuity testing by nurses and inspection by medical officers at regional Public Health Centers, and examinations by ophthalmologists. In this study, we tested refraction with a hand-held autorefractometer in addition to visual acuity testing and inspection to reveal whether or not autorefraction leads to better detection of eye problems. Autorefraction was performed in 6 consecutive sessions by a single examiner in 265 children at 3.5 years of age who all visited the same center. The children were sent to the third step of examinations by ophthalmologists based on refractive error criteria:3 diopters myopia or 1 diopter hyperopia, and/or 2 diopters astigmatism in either eye, in addition to the current criteria:1) failure in either eye for 0.5 visual acuity at the center, 2) eye-related symptoms revealed by the questionnaires, or 3) eye problems detected by medical officers. Notices to visit ophthalmologists were issued for 64 children (24%), and 37 of those (58%) made the visits, so that documents containing final diagnoses were sent back to the Public Health Office. Of the 64 children, 12 were sent to ophthalmologists based on the current criteria only, 10 based on both the current criteria and the refractive error criteria, and 42 based on the refractive error criteria only. Twelve of the 13 children visiting ophthalmologists by the current criteria had diagnoses such as amblyopia and strabismus. In contrast, 15 of 24 children visiting ophthalmologists by only the refractive error criteria had mainly diagnoses of refractive errors, with no serious problems. In conclusion, autorefraction in addition to visual acuity testing and inspection led to detection of only one additional case of an eye disease at 3.5 years, while tripling the number of children sending to the third-step examination by an ophthalmologist. Thus, from a cost-effectiveness standpoint, autorefraction is not recommended as an additional test when the current system is conducted as designed.
影响因子：
13.7
作者：
Schmidt, P;Ciner, E;Redford, M
通讯作者：
Redford, M
影响因子：
13.7
作者：
Borchert, Mark;Wang, Ying;Varma, Rohit
通讯作者：
Varma, Rohit