title: Accuracy of referrals from an orthoptic vision screening program for 3- to 4-year-old preschool children.
abstract: OBJECTIVE
  To determine the accuracy of orthoptist referrals from a preschool-based vision screening program for children 3-4 years of age and to report the outcomes of referred children.
  
  
  METHODS
  This was a retrospective review of records of participants in the preschool vision screening program in the Walsall, United Kingdom, area for the 2006-2007 school year. Screening examinations were performed by orthoptists and included assessment of visual acuity, ocular alignment, ocular motility, and stereoacuity.
  
  
  RESULTS
  For the 2006-2007 school year, 2,830 of 3,623 children (78%) were screened, Of these, 413 were referred to the Hospital Eye Service. Comparison of the screening results and the Hospital Eye Service examination revealed that recorded visual acuities were similar in 81% of subjects and ocular alignment in 94%. Visual acuity was 6/9 or better at the hospital examination in 87% of referred children, with 46% requiring spectacle use only; 17% of referrals were diagnosed with amblyopia.
  
  
  CONCLUSIONS
  Although the Walsall vision screening program diverged from UK national guidelines by testing at an earlier age, there was no evidence that earlier screening led to a large number of incorrect referrals, and early screening may allow for better outcomes. Sensitivity of screening was not tested, and orthoptist screening in the United Kingdom is likely to be more accurate in this age group than nonspecialist or lay screening that is performed in many other areas.
authors.affiliation: Wolverhampton Eye Infirmary, Wolverhampton, United Kingdom. victorhu@doctors.org.uk
authors.forename: Victor H
authors.initials: VH
authors.lastname: Hu
authors.forename: Amanda
authors.initials: A
authors.lastname: Starling
authors.forename: Shelagh N
authors.initials: SN
authors.lastname: Baynham
authors.forename: Hilary
authors.initials: H
authors.lastname: Wager
authors.forename: G Adrien
authors.initials: GA
authors.lastname: Shun-Shin
mesh_terms: D000550:Amblyopia / Q000175:diagnosis / Q000503:physiopathology; D002675:Child, Preschool; D004739:England; D005139:Eyeglasses / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000175:diagnosis; D009988:Orthoptics / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D012189:Retrospective Studies; D013285:Strabismus / Q000175:diagnosis; D014786:Vision Disorders / Q000175:diagnosis*; D015351:Vision Screening / Q000592:standards*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology