A new computer program for mass screening of visual defects in preschool children
a Department of Ophthalmology,
Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheba,
Israel, b Optitest Ofakim, Ofakim, Israel, c Faculty of Health Sciences, Ben-Gurion University
of the Negev, Beer-Sheba, Israel
Correspondence to: B Biedner, MD, Department of Ophthalmology, Soroka Medical Centre, PO Box 151, Beer-Sheba, Israel.
Accepted for publication 5 November 1997
AIMS
To test the effectiveness of a PC computer
program for detecting vision disorders which could be used by
non-trained personnel, and to determine the prevalence of visual
impairment in a sample population of preschool children in the city of
Beer-Sheba, Israel.
METHODS292 preschool children, aged 4-6 years,
were examined in the kindergarten setting, using the computer system
and "gold standard" tests. Visual acuity and stereopsis were tested
and compared using Snellen type symbol charts and random dot
stereograms respectively. The sensitivity, specificity, positive
predictive value, negative predictive value, and kappa test were
evaluated. A computer pseudo Worth four dot test was also performed but
could not be compared with the standard Worth four dot test owing to
the inability of many children to count.
RESULTSAgreement between computer and gold
standard tests was 83% and 97.3% for visual acuity and stereopsis
respectively. The sensitivity of the computer stereogram was only 50%,
but it had a specificity of 98.9%, whereas the sensitivity and
specificity of the visual acuity test were 81.5% and 83%
respectively. The positive predictive value of both tests was about
63%. 27.7% of children tested had a visual acuity of 6/12 or less and
stereopsis was absent in 28% using standard tests. Impairment of
fusion was found in 5% of children using the computer pseudo Worth
four dot test.
CONCLUSIONSThe computer program was found to be
stimulating, rapid, and easy to perform. The wide availability of
computers in schools and at home allow it to be used as an additional
screening tool by non-trained personnel, such as teachers and parents,
but it is not a replacement for standard testing.
© 1998 by British Journal of Ophthalmology
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