A new approach to vision screening in schools.

Abstract

To determine the prevalence of visual "defects" among a sample of young schoolchildren and evaluate a new system for vision screening in schools. A new system for vision screening in schools has been developed. The system is based on a computer program which may be run on a low specification personal computer. Information about the child's symptoms, history and family history is acquired by means of a parental questionnaire and entered into the program prior to the vision screening. Distance visual acuity and stereopsis are measured directly on the computer screen and colour vision is assessed using a reduced Ishihara test. The program carries out an "expert" analysis of the questionnaire data and the vision test results and determines the most likely diagnosis. Reports for parents, teachers, optometrists, doctors can be generated automatically and statistics relating to the overall screening program are available. An evaluation of a prototype version of the system was carried out on 245 schoolchildren aged between 5 and 8 years. Overall, 48 children failed the screening (excluding colour vision deficiencies), 32 of whom were unaware of any problem with their eyes. Comparison of the result of the vision screening with the outcome of a full eye examination gave a sensitivity of 93.8% and a specificity of 96.1%. A significant number of young school children have unsuspected remediable visual defects. The computer-based vision screener provides an efficient, sensitive and specific method for screening in schools.