No Benefit of a Pediatric Screening in Discovering Reduced Visual Acuity in Children: Experiences from a Cross-Sectional Study in Germany

Heike M. Elflein, Roman Pokora, Denis F. Müller, Klaus Jahn, Katharina A. Ponto, Susanne Pitz, Norbert Pfeiffer, Alexander K. Schuster and Michael S. Urschitz
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Heike M. Elflein: Department of Ophthalmology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany
Roman Pokora: Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany
Denis F. Müller: Department of Ophthalmology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany
Klaus Jahn: Ministry for Social Affairs, Labour, Health and Demography of Rhineland-Palatinate, Department of Public Health Services, Hygiene and Infection Control, 55131 Mainz, Germany
Katharina A. Ponto: Department of Ophthalmology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany
Susanne Pitz: Department of Ophthalmology, Bürgerhospital und Clementine Kinderhospital, 60318 Frankfurt/Main, Germany
Norbert Pfeiffer: Department of Ophthalmology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany
Alexander K. Schuster: Department of Ophthalmology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany
Michael S. Urschitz: Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, 55131 Mainz, Germany

IJERPH, 2020, vol. 17, issue 10, 1-10

Abstract: Background: The newly introduced German pediatric screening examination at the end of the third year of life (U7a) incorporates visual function testing in particular; there is no ophthalmic screening during childhood in Germany. The purpose of this study is to investigate the relationship between participation in U7a and visual function at the preschool health examination (PHE) in the sixth year of life. Methods: This study evaluated PHE data from school enrollment years 2009/2010 to 2014/2015 of Rhineland-Palatinate, Germany. Visual acuity (VA) at PHE was assessed with Rodenstock visual acuity test device (tumbling E) wearing glasses if present. The relationship between participation in U7a and VA <0.7 at PHE was calculated for reduced monocular and binocular VA using multiple logistic regression adjusted for potential confounders. Results: Data from 189,704 children (91,041 girls) in 35 out of 36 districts were included. The first children to participate in U7a were enrolled in 2011/2012 school year. In total, 90,339 children (47.6%) had U7a before PHE, while 99,365 (52.4%) had not. VA <0.7 in at least one eye was measured at PHE in 8429 (4.4%) children, and in both eyes in 4345 (2.3%) children. Participation in U7a was not associated with VA <0.7 at PHE (odds ratio 0.99; 95% confidence interval: 0.94–1.04). Conclusions: The proportion of children with VA <0.7 at PHE was high. No beneficial effect of newly introduced German U7a pediatric screening examination was found for reduced VA at PHE.

Keywords: amblyopia; preschool health examination; pediatric eye screening (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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