title: [Screening for amblyopia, strabismus and refractive abnormalities in 1,030 kindergarten children].
abstract: BACKGROUND
  There are controversies concerning the necessity of pre-school vision screening.
  
  
  OBJECTIVE
  evaluation of the prevalence of pathologic ophthalmologic findings in kindergarten children.
  
  
  METHODS
  1030 families were offered a vision screening. Of these, a total of 948 children, aged 3 to 6 years, voluntarily underwent a screening for strabismus, amblyopia and refractive anomalies. The examination was performed in the kindergarten in the absence of the parents. METHODS OF EXAMINATION: A questionnaire concerning general and ophthalmologic history of the child and of the family was evaluated. Visual acuity, cover-uncover-test, Lang-stereotest, retinoscopy, ophthalmoscopy (undilated pupils) were performed and the glasses were evaluated.
  
  
  RESULTS
  The screening was highly accepted by the parents and 92% of the families (n = 948) took part. The compliance of the children was very good. A total of 38.7% (n = 381) of the children showed one or more abnormal parameters. 21.4% (n = 229) showed a reduced visual acuity. Strabismus was found in 3.7%. Half of the children with abnormal findings already had had a vision screening, but only 25% had received ophthalmologic treatment. Of those who possessed glasses, 25% came without them, and another 25% had a reduced visual acuity even with their glasses. The main problems were many false-positive results and high costs.
  
  
  CONCLUSIONS
  Ophthalmologic and orthoptic screening in kindergarten is technically easy and conclusive in experienced hands. Ideas to reduce costs and to avoid overreferrals are an age-related lowering of the visual acuity limit and a rescreening of suspected children in a screening-setting a second time before sending them to an ophthalmologist. Another possibility to reduce costs would be to perform examinations not by ophthalmologists but by "screening-orthoptists" who should be trained in retinoscopy and ophthalmoscopy.
authors.affiliation: Orthoptik und Kinderophthalmologie, Universität des Saarlandes, Homburg, Saar.
authors.forename: B
authors.initials: B
authors.lastname: Käsmann-Kellner
authors.forename: M
authors.initials: M
authors.lastname: Heine
authors.forename: B
authors.initials: B
authors.lastname: Pfau
authors.forename: A
authors.initials: A
authors.lastname: Singer
authors.forename: K W
authors.initials: KW
authors.lastname: Ruprecht
mesh_terms: D000550:Amblyopia / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009887:Ophthalmoscopy; D012030:Refractive Errors / Q000175:diagnosis* / Q000453:epidemiology; D013285:Strabismus / Q000175:diagnosis* / Q000453:epidemiology; D015351:Vision Screening; D014787:Vision Tests