Amblyopia prophylaxis in the Nienburg/Weser district
G. Freitag, S. Peukert, W. Kesper, K.-C. Schipper
Background: From December 1998 to February 2000 an orthoptic mass screening was organised in the kindergartens of the Nienburg district. The survey was carried out on a total of 1077 children, aged 2 to 6 years. The target was an early diagnosis of amblyopia, strabism and optical anomaly.
Methods: For the screening the following standardised examinations were carried out by an orthoptist:
1. orthoptic status (cover-test, examination of motility and convergence, testing of binocularity: Lang-test, TNO-test);
2. examination of visual acuity (in accordance to age by LH-test or with E-hook); 3. skiascopy in miosis for diagnosis of higher grade refraction anomalies; 4. anamnesis (family medical history, troubles).
Results: 74 children (6.9%) out of a total of 1077 examined children were treated by an ophtalmologist (glasses, amblyopia therapy). On 668 children (62%) we noted no particular findings. The definition for "normal state" was as follows: same acuity of vision = 0.9, no findings on position or motility and full binocularity. Particular findings were stated on a quantity of 409 children (38%) in total, thereof 276 children with reduced vision. 101 children (9.4%) showed deviations in vision but no amblyopia. On 140 children (13%), reduced vision on both eyes had to noted. Amblyopia was diagnosed on 35 children (3.3%), whereof 10 children were not treated. Alterations of binocularity such as strabism, altered motility or nystagmus were found on 109 children (10.1%). For a quantity of 24 children (2.2%) no results could be noted due to their non-compliance.
Conclusions: Only a total of 35 amblyopia (3.3%) were found in contrast to a prevalence of 5% to 6% (W. Haase). In our opinion, this is a result of the good co-operation between pediatrists and ophtalmologists aiming at prophylaxis and early diagnosis of amblyopia and their relevant risk factors. A total of 38% of all children tested showed particular status of the eyes that needed further control. We think that a field covering application of this orthoptic screening does make sense. That is the reason for the foundation of the incorporated society "Verein zur Förderung der Früherkennung von Fehlern des visuellen Systems im Vorschulalter e.V." supporting early diagnosis of vision defects of pre-school aged children.
G. Freitag, Lange Str. 61, D 31582 Nienburg