title: Amblyopia screening in Bulgaria.
abstract: OBJECTIVE
  To determine the prevalence of amblyopia and the average age at first ophthalmological examination of school-aged children from northwestern Bulgaria.
  
  
  METHODS
  Visual acuity testing, stereopsis, orthoptics, ocular motility, non-cycloplegic refraction, direct ophthalmoscopy, and external ocular inspection were performed. Cycloplegic refraction and indirect ophthalmoscopy were done as necessary. A total of 2,054 children (1,020 girls and 1,034 boys) were divided into three age groups: 6 to 8 years (803 children), 8 to 10 years (719 children), and 10 to 12 years (530 children).
  
  
  RESULTS
  A total of 1,861 children (90.6%) received their first examination: 754 (93.9%) aged 6 to 8 years, 638 (88.7%) aged 8 to 10 years, and 469 (88.2%) aged 10 to 12 years. Amblyopia was detected in 88 children (4.3%): 42 (5.2%) aged 6 to 8 years, 27 (3.8%) aged 8 to 10 years, and 19 (3.6%) aged 10 to 12 years. The first group had higher prevalence compared to countries with well-developed screening programs. Refractive errors were detected in 403 children (19.7%): 125 (15.6%) aged 6 to 8 years, 146 (20.3%) aged 8 to 10 years, and 132 (24.8%) aged 10 to 12 years. The estimated prevalence increases with age. Strabismus was detected in 24 children (1.2%): 8 (1.0%) aged 6 to 8 years, 7 (1.0%) aged 8 to 10 years, and 9 (1.7%) aged 10 to 12 years.
  
  
  CONCLUSIONS
  The lack of screening programs in Bulgaria is the main reason for late diagnosis of amblyopia. The "Do Good "project provided eye examination of school-aged children aged 6 to 12 years, when amblyopia is curable. This model could be used in establishing a Bulgarian national screening program.
authors: Alexander
authors: A
authors: Oscar
authors: Sylvia
authors: S
authors: Cherninkova
authors: Vasil
authors: V
authors: Haykin
authors: Ani
authors: A
authors: Aroyo
authors: Alina
authors: A
authors: Levi
authors: Nikolay
authors: N
authors: Marinov
authors: Stanislava
authors: S
authors: Kostova
authors: Chavdar
authors: C
authors: Elenkov
authors: Nevyana
authors: N
authors: Veleva
authors: Violeta
authors: V
authors: Chernodrinska
authors: Iva
authors: I
authors: Petkova
authors: Jeffrey
authors: J
authors: Spitzer
mesh_terms: D017677:Age Distribution; D000550:Amblyopia / Q000175:diagnosis / Q000453:epidemiology*; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D003867:Depth Perception / Q000502:physiology; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009887:Ophthalmoscopy; D015995:Prevalence; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000453:epidemiology; D017678:Sex Distribution; D015351:Vision Screening; D014792:Visual Acuity / Q000502:physiology