title: Effectiveness of screening for amblyopia and other eye disorders in a prospective birth cohort study.
abstract: OBJECTIVE
  To establish whether the current vision screening practice in the Netherlands is effective in preventing permanent visual loss and to estimate the sensitivity of the programme.
  
  
  METHODS
  In the Netherlands, all children are invited for preverbal (1, 3, 6-9 and 14-24 months) and preschool (36, 45, and 60-72 months) vision screening. Screening attendance is high, but the effectiveness in reducing amblyopia is unknown.
  
  
  METHODS
  In a 7-year cohort study, 4624 children born in the city of Rotterdam between 16 September 1996 and 15 May 1997 were followed through all routine vision screening examinations. At age seven, visual acuity (VA) of children still living in Rotterdam was assessed by study orthoptists. In case of VA > 0.1 logMAR in one or both eyes, two or more logMAR lines of interocular difference or eye disorders like strabismus, children underwent a more intensive eye examination.
  
  
  RESULTS
  Attendance at the 9-month screening was 89%, decreasing to about 75% at later examinations. Of preverbal tests, 2.5% were positive, and of preschool tests, 10%. In total, 19% of children had a positive vision screening test at least once. Amblyopia prevalence was 3.4%. Sensitivity of the vision screening programme was 73% and specificity 83%. At age seven, 0.7-1.2% (confirmed vs final exam) of the children had a VA > 0.3 logMAR in the worse eye compared with 2-3.9% (in literature) reported prevalence in non-screening situations. Children who were less frequently screened had a higher chance of poor vision (>0.3 logMAR) at age seven.
  
  
  CONCLUSIONS
  The Dutch child vision screening programme may reduce the risk of persistent amblyopia (VA > 0.3 logMAR) at age seven by more than half.
authors.affiliation: Dept. of Public Health, Erasmus MC Dr. Molewaterplein 50 3015 GE Rotterdam, the Netherlands.
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.forename: Johanna H
authors.initials: JH
authors.lastname: Groenewoud
authors.forename: V Kathleen
authors.initials: VK
authors.lastname: Lantau
authors.forename: A M
authors.initials: AM
authors.lastname: Tjiam
authors.forename: W Christina
authors.initials: WC
authors.lastname: Hoogeveen
authors.forename: Jan Tjeerd H N
authors.initials: JT
authors.lastname: de Faber
authors.forename: Rikard E
authors.initials: RE
authors.lastname: Juttmann
authors.forename: Huibert J
authors.initials: HJ
authors.lastname: Simonsz
mesh_terms: D000550:Amblyopia / Q000175:diagnosis*; D002675:Child, Preschool; D005128:Eye Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D015351:Vision Screening / Q000379:methods*