EXTENDED REPORT

The Seoul Metropolitan Preschool Vision Screening Programme: results from South Korea

H T Lim¹, Y S Yu², S-H Park³, H Ahn¹, S Kim⁷, M Lee⁷, J-Y Jeong⁶, K H Shin^4,7 and B S Koo^5,7

¹ Department of Ophthalmology, Ulsan University College of Medicine, Seoul, South Korea
² Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
³ Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, South Korea
⁴ Department of Ophthalmology, Gacheon College of Medicine, Incheon, South Korea
⁵ Department of Ophthalmology, Sung-Ae General Hospital, Seoul, South Korea
⁶ School of Public Health, Seoul National University, Seoul, South Korea
⁷ Korean Foundation for the Prevention of Blindness, Seoul, South Korea

Correspondence to:
Correspondence to:
Dr S Kim
MPH, Korean Foundation for the Prevention of Blindness, Room 704, Sung-Ji Building, 538 Dohwa-2-Dong, Mapo-Gu, Seoul, 121-743, South Korea; KFPB1102{at}kornet.net

Aim: To report on a new model of preschool vision screening that was performed in metropolitan Seoul and to investigate the distribution of various ocular disorders in this metropolitan preschool population.

Methods: Vision screening was conducted on 36 973 kindergarten children aged 3–5 years in a stepwise manner. The first step was home screening using a set of five picture cards and a questionnaire. The children who did not pass the first step (VA <0.5 in at least one eye or any abnormal responses on the questionnaire) were retested with regular vision charts at the regional public healthcare centres. After this retest, some children were referred to ophthalmologists. The referral criteria for visual acuity were <0.5 at 3 years and <0.63 at 4 or 5 years in at least one eye.

Results: Of those screened, 7116 (19.2%) children did not pass the home screening tests and 2058 (28.9%) out of the 7116 were referred. The results of the ophthalmological examination in eye clinics were only available for 894 children (43.4%) of those who were referred. The rest of the children did not visit ophthalmologists because they had been checked at an eye clinic, were currently under treatment, or for personal reasons. Refractive errors were found in 608 (1.6%) children. Astigmatism was associated in 78.2% of ametropes. Amblyopia was discovered in 149 (0.4%) children and refractive error was the major aetiology with a predominant rate (82.5%). Manifest strabismus was detected in 52 children. The positive predictive value of vision screening for any ophthalmological disorder was 0.77, and 0.49 for significant disorders requiring treatment.

Conclusions: This preschool vision screening model was highly accessible to the children and their parents, easy to administer, and effective to detect a variety of ocular disorders. However, the participation rate of the referred children in the examinations by ophthalmologists was quite low. The performance and efficiency of this screening programme need to be optimised with further revision.

Abbreviations: KFPB, Korean Foundation for the Prevention of Blindness; PHC, public healthcare centres; PPV, positive predictive value; VA, visual acuity

Keywords: amblyopoa; preschool vision screening; refractive error; Seoul; South Korea

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This article has been cited by other articles:

• Arnold, R W, Ruben, J, Donahue, S P, AAPOS Vision Screening Committee, (2005). Korean kindergarten vision screen programme. Br. J. Ophthalmol. 89: 392-393 [Full Text]  

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Korean Kindergarten Vision Screen Program

Robert W Arnold, et al.

BJO Online, 11 Aug 2004 [Full text]