Alison Bruce1,2, Gillian Santorelli3, John Wright3, John Bradbury4, Brendan T Barrett5, Marina Bloj5, Trevor A Sheldon6. 1. Department of Health Sciences, University of York, York, UK. alison.bruce@bthft.nhs.uk. 2. Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, UK. alison.bruce@bthft.nhs.uk. 3. Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, UK. 4. Bradford Teaching Hospitals Foundation Trust, Bradford, UK. 5. School of Optometry and Vision Science, University of Bradford, Bradford, UK. 6. Department of Health Sciences, University of York, York, UK.
Abstract
PURPOSE: To determine presenting visual acuity levels and explore the factors associated with failing vision screening in a multi-ethnic population of UK children aged 4-5 years. METHODS: Visual acuity (VA) using the logMAR Crowded Test was measured in 16,541 children in a population-based vision screening programme. Referral for cycloplegic examination was based on national recommendations (>0.20logMAR in one or both eyes). Presenting visual impairment (PVI) was defined as VA >0.3logMAR in the better eye. Multivariable logistic regression was used to assess the association of ethnicity, maternal, and early-life factors with failing vision screening and PVI in participants of the Born in Bradford birth cohort. RESULTS: In total, 2467/16,541 (15%) failed vision screening, 732 (4.4%) had PVI. Children of Pakistani (OR: 2.49; 95% CI: 1.74-3.60) and other ethnicities (OR: 2.00; 95% CI: 1.28-3.12) showed increased odds of PVI compared to white children. Children born to older mothers (OR: 1.63; 95% CI: 1.19-2.24) and of low birth weight (OR: 1.52; 95% CI: 1.00-2.34) also showed increased odds. Follow-up results were available for 1068 (43.3%) children, 993 (93%) were true positives; 932 (94%) of these had significant refractive error. Astigmatism (>1DC) (44%) was more common in children of Pakistani ethnicity and hypermetropia (>3.0DS) (27%) in white children (Fisher's exact, p < 0.001). CONCLUSIONS: A high prevalence of PVI is reported. Failing vision screening and PVI were highly associated with ethnicity. The positive predictive value of the vision screening programme was good, with only 7% of children followed up confirmed as false positives.
PURPOSE: To determine presenting visual acuity levels and explore the factors associated with failing vision screening in a multi-ethnic population of UK children aged 4-5 years. METHODS: Visual acuity (VA) using the logMAR Crowded Test was measured in 16,541 children in a population-based vision screening programme. Referral for cycloplegic examination was based on national recommendations (>0.20logMAR in one or both eyes). Presenting visual impairment (PVI) was defined as VA >0.3logMAR in the better eye. Multivariable logistic regression was used to assess the association of ethnicity, maternal, and early-life factors with failing vision screening and PVI in participants of the Born in Bradford birth cohort. RESULTS: In total, 2467/16,541 (15%) failed vision screening, 732 (4.4%) had PVI. Children of Pakistani (OR: 2.49; 95% CI: 1.74-3.60) and other ethnicities (OR: 2.00; 95% CI: 1.28-3.12) showed increased odds of PVI compared to white children. Children born to older mothers (OR: 1.63; 95% CI: 1.19-2.24) and of low birth weight (OR: 1.52; 95% CI: 1.00-2.34) also showed increased odds. Follow-up results were available for 1068 (43.3%) children, 993 (93%) were true positives; 932 (94%) of these had significant refractive error. Astigmatism (>1DC) (44%) was more common in children of Pakistani ethnicity and hypermetropia (>3.0DS) (27%) in white children (Fisher's exact, p < 0.001). CONCLUSIONS: A high prevalence of PVI is reported. Failing vision screening and PVI were highly associated with ethnicity. The positive predictive value of the vision screening programme was good, with only 7% of children followed up confirmed as false positives.
Authors: Susan A Cotter; Rohit Varma; Kristina Tarczy-Hornoch; Roberta McKean-Cowdin; Jesse Lin; Ge Wen; Jolyn Wei; Mark Borchert; Stanley P Azen; Mina Torres; James M Tielsch; David S Friedman; Michael X Repka; Joanne Katz; Josephine Ibironke; Lydia Giordano Journal: Ophthalmology Date: 2011-08-19 Impact factor: 12.079
Authors: Jenny M Ip; Dana Robaei; Annette Kifley; Jie Jin Wang; Kathryn A Rose; Paul Mitchell Journal: Ophthalmology Date: 2007-07-30 Impact factor: 12.079