VISION SCREENING OF 4-YEAR-OLD CHILDREN
VISION SCREENING OF 4-YEAR-OLD CHILDREN
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DOI：
10.1111/j.1651-2227.1973.tb08060.x
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发表时间：
1973-01-01
期刊：
影响因子：
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通讯作者：
STIGMAR, G
中科院分区：
文献类型：
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作者：
KOHLER, L;STIGMAR, G
在未选择的2447名4岁儿童人群的一般健康对照中，使用视力检查（Marquez‐Bostrom钩）、遮盖试验和维尔特Fly立体视觉试验进行视力筛查。筛查可在98%的儿童中进行。364名儿童（15.2%）因新发现的视力缺陷而被转诊，358名儿童（15.0%）接受了专业检查。其中，40.8%的患者视力≤0.6，5.9%的患者视力≤0.1。功能性弱视占12.3%，显性斜视占10.3%，屈光不正以远视为主近视眼占3.9%，近视眼占28.5%。根据儿童是否需要专业护理，其中第0组表示过度转诊，第2-3组表示需要眼科治疗和/或观察的“严重眼部疾病”。16.5%的患者过度转诊，43%的患者出现严重眼部疾病。通过视力检查，发现97%的儿童患有眼部疾病。未通过测试的儿童重新测试，将过度转诊从39.5%降至12.5%（p<0.001）。通过降低视力检查的合格标准，被过度转诊的儿童会更少，但同时，需要治疗的儿童中有1/5会被发现。包括已经接受专业护理的儿童在内，在这份4岁儿童的调查材料中，斜视的患病率略低于4%，需要矫正眼镜的比例约为8%。据报道，有家族眼疾、分娩并发症或目前眼部不适的儿童处于严重眼疾的风险区，但这些来自父母的信息没有足够的选择性，作为一种筛查方法没有实用价值。一个由73名儿童组成的小型对照组和3年后在学校随访的479名儿童，结果显示，在筛查测试中没有遗漏任何功能性弱视儿童。
Included in a general health control of an un‐selected population of 2 447 four‐year‐old children, a vision screening was performed, using a visual acuity test (Marquez‐Bostrom's hooks), cover test and Wirt Fly Stereo test. The screening could be carried out in 98% of the children. 364 children (15.2%) were referred because of newly detected visual defects, and 358 children (15.0%) were professionally examined. Of these, 40.8% had a visual acuity of ≤0.6 and 5.9% of ≤0.1. Functional amblyopia was found in 12.3% and manifest strabismus in 10.3%, The main error of refraction was hyperopia (≥ 2.5 D), diagnosed in 28.5%, while myopia was infrequent, 3.9%.The children examined by the ophthalmologist were also classified into four groups, according to their need of professional care, where group 0 means overreferral and groups 2–3 represent “significant eye disorders”, in need of ophthalmological treatment and/or observation. Overreferral was found in 16.5% and significant eye disorders in 43%. With the visual acuity test, 97% of the children with eye disorders were detected. Retesting children, who failed the tests, reduced the over‐referral from 39.5% to 12.5% (p<0.001). By lowering the passing standards of the visual acuity test, still fewer children would have been overreferred, but, at the same time, 1/5 of children needing treatment would then have remained undiscovered.Including children already under professional care, the prevalence of strabismus in this unselected material of 4‐year‐old children was just below 4%, and the need for corrective glasses around 8%.Children reported to have family eye disorders, partus complications or present eye complaints were in the risk zone for suffering significant eye disorders, but this information from the parents was not sufficiently selective to be of practical value as a screening method.A small control group of 73 children and a follow‐up of 479 children at school 3 years later, revealed that no children with functional amblyopia were missed at the screening test.