A NEW COMPUTER-PROGRAM FOR MASS-SCREENING OF VISUAL DEFECTS IN PRESCHOOL-CHILDREN

Aims-To test the effectiveness of a PC computer program for detecting vision disorders which could be used by nontrained personnel, and to d etermine the prevalence of visual impairment in a sample population of preschool children in the city of Beer-Sheba, Israel. Methods-292 pre school children, aged 4-6 years, were examined in the kindergarten set ting, using the computer system and '(gold standard)) tests. Visual ac uity and stereopsis were tested and compared using Snellen type symbol charts and random dot stereograms respectively. The sensitivity, spec ificity, positive predictive value, negative predictive value, and kap pa test were evaluated. A computer pseudo Worth four dot test was also performed but could not be compared with the standard Worth four dot test owing to the inability of many children to count. Results-Agreeme nt between computer and gold standard tests was 83% and 97.3% for visu al acuity and stereopsis respectively. The sensitivity of the computer stereogram was only 50%, but it had a specificity of 98.9%, whereas t he sensitivity and specificity of the visual acuity test were 81.5% an d 83% respectively. The positive predictive value of both tests was ab out 63%. 27.7% of children tested had a visual acuity of 6/12 or less and stereopsis was absent in 28% using standard tests. Impairment of f usion was found in 5% of children using the computer pseudo Worth four dot test. Conclusions-The computer program was found to be stimulatin g, rapid, and easy to perform. The wide availability of computers in s chools and at home allow it to be used as an additional screening tool by non-trained personnel, such as teachers and parents, but it is not a replacement for standard testing.