Vision Screening

Question 1

What states require exams for children?

Answer 1

• Kentucky
• Missouri
• Illinois
• California

Question 2

What % of children have not visited an eye care provider in the past year?

Answer 2

79%

Question 3

What % of children have never seen an eye care professional?

Answer 3

35%

Question 4

How do you best find children with vision problems?

Answer 4

Vision screenings

Question 5

Federal law states Head start requires all children screened within __ days of entry.

Answer 5

45 days

Question 6

What % of children who fail initial vision screening do not reeive the appropriate follow up care?

Answer 6

40%

Question 7

What test are used for vision screenings?

Answer 7

1. Visual Acuity Tests
2. Eye alignment Tests
3. Refractive Error
4. Photoscreeners

Question 8

What are the goals of VIP (vision in preschoolers)?

Answer 8

1. identify whether there are vision screening tests can accurately predict 3 & 4 yo at risk
2. what test can be used by nurses and lay screeners to empower communities

Question 9

What is the most frequently occurring vision disorder?

Answer 9

Refractive Error

Question 10

If RE is left uncorrected, what can it cause?

Answer 10

• amblyopia
• strabismus
• interfere with performance

Question 11

If strabismus is left uncorrected, what can it cause?

Answer 11

1. Amblyopia

2. Reduced or absent binocularity and steropsis

Question 12

Early detection and treatment can help with what 2 things?

Answer 12

1. prevent loss of vision

2. decrease negative impact

Question 13

Group 1 conditions are Very important to detect early. What are the conditions?

Answer 13

• Amblyopia worse than 20/64
• Constant strabismus or eye turn
• Refractive Errors

Question 14

What refractive errors are important in group 1 conditions?

Answer 14

• Moderate to high hyperopia
• High myopia
• Moderate astigmatism
• Severe anisometropia

Question 15

There was a ___% specificity to determine group 1 conditions?

Answer 15

90%

Question 16

What are the best tests for group 1 conditions?

Answer 16

• High tech

- Low tech

Question 17

What are the characteristics of screening tests?

Answer 17

1. High specificity and sensitivity
2. safe to administer
3. reasonable costs
4. Improved health outcomes
5. widely available

Question 18

A sensitivity of 90% means what?

Answer 18

Identifies 90 of 100 children with a problem

- failed to identify 10 children

Question 19

A specificity of 90% means what?

Answer 19

• Only 10 of 100 children are without a problem

- correctly identified 90 children with normal vision

Question 20

This is the probability that a test will indicate the patients with the condition.

Answer 20

Sensitivity

Question 21

This is the percentage of children without the condition who will have a negative test result

Answer 21

Specificity

Question 22

What are the 2 main visual acuity test used to screen children?

Answer 22

HOTV VA

Lea Symbols VA

Question 23

What is the best test distance for a preschool vision screening?

Answer 23

5 feet

Question 24

What type of eye patch is best?

Answer 24

Pear shaped sticky eye patch

Question 25

What is the sensitivity of Lea Symbols? HOTV when an OD or MD is the screener?

Answer 25

Lea = 77% (77/100 children are found WITH a problem) HOTV = 72%

Question 26

What is the sensitivity when the nurses or lay persons are screeners?

Answer 26

Lea/HOTV = 50-60%

Question 27

Single crowded lea symbols should be tested at what distance?

Answer 27

5 feet

Question 28

What is the 3 and 4/5 yo passing criteria for Lea wheel ?

Answer 28

3 yo = 20/50 | 4/5yo = 20/40

Question 29

What modifications were made to test lea symbols in preschoolers?

Answer 29

- 5 ft wheel works best | - Use patch glasses (fun)

Question 30

What is best to test a patient's refractive error?

Answer 30

noncycloplegic retinoscopy

Question 31

What are the 3 main tests that assess refraction? What is the testability?

Answer 31

- Noncycloplegic Ret - Retinomax Autorefractor - Suresight Vision Screener - 98% in 3-5 yo

Question 32

What was the sensitiviity of NCR and retinomax when eye examiners did it?

Answer 32

- NCR = 90% | - Retinomax = 88%

Question 33

What are the eye alignment screening tests?

Answer 33

1. Cover test 2. Randot E 3. Stereo Smile

Question 34

Which 2 eye alignement tests have the best testability?

Answer 34

CT and Stereo Smile

Question 35

Which test eye alignment test has the best sensitivity?

Answer 35

- Stereo smile | - 72% sensitivity vs. 60% in CT

Question 36

Name the top 4 best test to use during pediatric vision screenings.

Answer 36

1. Retinomax AR 2. Suresight Vision Screener 3. LEA symbols at 5 ft w/ patch glasses 4. Stereo Smile for strabismus