ArticleBMJ open2019
Choosing appropriate tools and referral criteria for vision screening of children aged 4-5 years in Canada: a quantitative analysis.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Assessment of the Spot vision screener performance in detecting amblyopia and strabismus in Nepal: a prospective diagnostic accuracy study.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026Article
- Instrument-Based Screening for the Detection of Amblyopia and Amblyopia Risk Factors: A Report by the American Academy of Ophthalmology.Ophthalmology · 2025Review
- Comparing paediatric optometric vision care in Canada over a 14-year period.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2024Article
- Cost-effectiveness of Universal School- and Community-Based Vision Testing Strategies to Detect Amblyopia in Children in Ontario, Canada.JAMA network open · 2023Article
- Evaluation of the Blinq Vision Screener in the Detection of Amblyopia and Strabismus in Children.Translational vision science & technology · 2022Article
- The UCI EyeMobile Preschool Vision Screening Program: Refractive Error and Amblyopia Results from the 2019-2020 School Year.Clinical ophthalmology (Auckland, N.Z.) · 2022Article
- Artificial intelligence improves accuracy, efficiency, and reliability of a handheld infrared eccentric autorefractor for adult refractometry.International journal of ophthalmology · 2022Article
- Functional Imaging in Improving Children's Mental Health Based on Behavior.Computational and mathematical methods in medicine · 2022Article
- 2020 Evaluation of Portable Vision Screening Instruments.The Yale journal of biology and medicine · 2021Article
- Feasibility of a school-based vision screening program to detect undiagnosed visual problems in kindergarten children in Ontario.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
- A Multihead Attention Deep Learning Algorithm to Detect Amblyopia Using Fixation Eye Movements.Ophthalmology scienceArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo assess the diagnostic accuracy of five vision screening tools used in a school setting using sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).
designWe compared the results of the five best evidence-based screening tools available in 2014 to the results of a comprehensive eye exam with cycloplegic refraction by a licenced optometrist. Screening included Cambridge Crowded Acuity Cards, Plusoptix S12 and Spot photoscreeners, Preschool Randot Stereoacuity Test and the Pediatric Vision Scanner (PVS). Referral criteria followed AAPOS (2013) guidelines and published norms.
settingA large school in Toronto, Canada, with 25 split classrooms of junior kindergarten (JK: 4 year olds) and senior kindergarten (SK: 5 year olds) children.
participantsOver 2 years, 1132 eligible children were enrolled at the school. After obtaining parental consent, 832 children were screened. Subsequently, 709 children had complete screening and optometry exam data.
main outcome measuresThe presence/absence of a visual problem based on optometrist's assessment: amblyopia, amblyopia risk factors (reduced stereoacuity, strabismus and clinically significant refractive errors) and any other ocular problem (eg, nystagmus).
resultsOverall, 26.5% of the screened children had a visual problem, including 5.9% with amblyopia. Using all five tools, screening sensitivity=84% (95% CI 78 to 89), specificity=49% (95% CI 44 to 53), PPV=37% (95% CI 33 to 42), and NPV=90% (95% CI 86 to 93). The odds of having a correct screening result in SK (mean age=68.2 months) was 1.5 times those in JK (mean age=55.6 months; 95% CI 1.1 to 2.1), with sensitivity improved to 89% (95% CI 80 to 96) and specificity improved to 57% (95% CI 50 to 64) among SK children.
conclusionsA school-based screening programme correctly identified 84% of those kindergarten children who were found to have a visual problem by a cyclopleged optometry exam. Additional analyses revealed how accuracy varies with different combinations of screening tools and referral criteria.
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