Abstract
BackgroundThe AAP vision screening guidelines are not uniformly delivered. Moderate amblyopia can be successfully treated in children 7 years of age and older. The ideal method and threshold of vision and/or acuity testing in school is not known.Methods1700 students from first grade, kindergarten, and pre-kindergarten were screened with a flip-card, surround HOTV protocol with other eye patched combined with photoscreening; 234 students had “Gold Standard” confirmatory exams from which AAPOS standards were validated.ResultsReceiver Operator Curves were constructed by adjusting referral criteria by grade. A cut-off of 20/25 yielded fairly good (50%) sensitivity and 90% specificity for first grade and kindergarten, but many of the pre-kindergarten were unable to complete the testing.ConclusionPatched surround HOTV flip-card acuity is useful in starting school children and a cut-off of 20/25 passing acuity is suggested. Pre-kindergarten are not well acuity screened due to high inconclusive rate.
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