Intervention Review

Vision screening for correctable visual acuity deficits in school-age children and adolescents

  1. Christine Powell1,*,
  2. Susanne Wedner2,
  3. Sarah R Hatt3

Editorial Group: Cochrane Eyes and Vision Group

Published Online: 18 OCT 2004

Assessed as up-to-date: 3 APR 2006

DOI: 10.1002/14651858.CD005023.pub2


How to Cite

Powell C, Wedner S, Hatt SR. Vision screening for correctable visual acuity deficits in school-age children and adolescents. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD005023. DOI: 10.1002/14651858.CD005023.pub2.

Author Information

  1. 1

    Royal Victoria Infirmary, Department of Ophthalmology, Newcastle upon Tyne, UK

  2. 2

    London School of Hygiene & Tropical Medicine, International Centre for Eye Health, London, UK

  3. 3

    Mayo Clinic, Ophthalmology Research, Rochester, USA

*Christine Powell, Department of Ophthalmology, Royal Victoria Infirmary, Claremont Wing, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK. christine.powell2@nuth.nhs.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 OCT 2004

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Although the benefits of vision screening seem intuitive the value of such programmes in junior and senior schools has been questioned. In addition to this, there exists a lack of clarity regarding the optimum age for screening and frequency at which to carry out screening.

Objectives

The objective of this review was to evaluate the effectiveness of vision screening programmes carried out in schools in reducing the prevalence of undetected, correctable visual acuity deficits due to refractive error in school-age children.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register, in The Cochrane Library (2006, Issue 1), MEDLINE (1966 to March 2006) and EMBASE (1980 to March 2006). No language or date restrictions were placed on these searches.

Selection criteria

We planned to include randomised controlled trials, including randomised cluster controlled trials.

Data collection and analysis

Two review authors independently assessed study abstracts identified by the electronic searches. No trials were identified that met the inclusion criteria.

Main results

As no trials were identified, no formal analysis was performed. A narrative synthesis of other retrieved studies was undertaken in order to explain current practice.

Authors' conclusions

At present there are no robust trials available that allow the benefits of school vision screening to be measured. The disadvantage of attending school with a visual acuity deficit also needs to be quantified. The impact of a screening programme will depend on the geographical and socio-economic setting in which it is conducted. There is, therefore, clearly a need for well-planned randomised controlled trials to be undertaken in various settings so that the potential benefits and harms of vision screening can be measured.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Screening school aged children and adolescents for reduced vision caused by the need for glasses

Worldwide, the leading cause of reduced vision in children is an unidentified need for them to wear glasses. The reduced vision that results from abnormal focusing (refractive error) can cause the children to screw up their eyes and complain of headaches. Reduced vision may affect academic performance, choice of occupation and socio-economic status in adult life. Genetic and environmental factors are known to affect the development of refractive error; it is also more common in certain racial groups. Short sightedness has become the commonest eye condition. The need to correct refractive error is determined by its effect on vision. Normal vision can usually be restored by wearing corrective glasses or contact lenses. However, there is some evidence that correction may cause an error to persist where it might otherwise have resolved or reduced naturally. Vision screening is used widely but is concentrated in developed countries; in developing countries it may serve the purpose of providing access to health care. The value of screening after school entry has been queried. Programmes vary with regard to testing personnel, set threshold for failure, frequency and setting. The disability caused by a vision deficit has not been quantified and the optimum age and number of occasions for screening have not been established. The aim of this review was to find studies that evaluated the effectiveness of school vision screening programmes in first identifying children with reduced vision. No eligible randomised studies were found. There is a clear need for reliable evidence to measure the effectiveness of vision screening. A narrative synthesis of other retrieved studies was undertaken in order to explain current practice.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

學齡孩童和青少年之可矯治視力缺損的視力篩檢

雖然直覺上視力篩檢似乎有好處,此計畫在初中與高中的價值已受到質疑。除此之外,尚不清楚合適篩檢的年齡與進行篩檢的次數。

目標

這篇回顧的目的是評估學校進行視力篩檢計畫對於減少學齡孩童未察覺,與因為折射偏差造成可矯治視力缺損之盛行率的效果。

搜尋策略

我們檢索the Cochrane Central Register of Controlled Trials (CENTRAL),其包含考科藍圖書館中的the Cochrane Eyes and Vision Trials Register(2006年,第1期),MEDLINE (1966至2006年3月)與EMBASE (1980至2006年3月)。這些檢索策略沒有限制語言或日期。

選擇標準

納入隨機對照試驗,包括隨機的群組對照試驗。

資料收集與分析

兩名回顧作者分別評估電子檢索找到的研究摘要。沒有找到符合納入標準的試驗。

主要結論

由於沒有找到相關的試驗,因此沒有進行正式的分析。綜合描述其他的研究以解釋目前的做法。

作者結論

目前沒有強而有力的試驗可以測量學校視力篩檢的好處。另外也需要量化視力缺損的孩童其上學的壞處。篩檢計畫的影響將取決於執行的地理與社會經濟環境。因此,很明顯地需要在各種機構執行規劃良好的隨機對照試驗,以測量視力篩檢可能的好處與害處。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

篩檢學齡孩童與青少年是否視力力下降而需要配戴眼鏡。 全世界,孩童視力下降的主因是未發現他需要配戴眼鏡。因為不正常聚焦(折射偏差)造成的視力下降會造成孩童瞇眼並有頭痛的困擾。視力下降也許會影響成年後的學校表現,職業選擇與社會經濟狀態。已知基因與環境因子會影響折射偏差的發生;在某種種族中也很常見。近視是最常見的眼睛問題。是否需要矯治折射偏差取決於它對視力的影響。一般視力通常可以經由配戴矯正眼鏡或隱形眼鏡而恢復。然而,有一些證據指出矯正也許會造成原本可以被解決或自然地減輕的折射偏差持續存在。視力篩檢被廣泛地使用,但主要集中在已開發國家;在發展中國家,也許可以藉由提供可近的健康照護而達到目的。在入學後視力篩檢的價值已被質疑。計畫各不相同,包括測試人員,失敗的閾值,次數與機構。因為視力缺損造成的失能尚未被量化,且合適篩檢的年齡與篩檢次數也不確定。這篇回顧的目的是尋找評估視力篩檢計畫能夠確定第一次篩檢出視力下降孩童之效果的研究。沒有找到合格的隨機研究。很明顯的需要可靠的證據關於測量視力篩檢的效果。綜合描述其他的研究已解釋目前的做法。