Sensitivity and specificity of school nurse screening for hypermetropia and convergence insufficiency exophoria in primary schoolchildren in Denmark

摘要

Abstract Background To determine the sensitivity and specificity of school nurse screening for hypermetropia and convergence insufficiency exophoria (CIE) in schoolchildren. Methods Near point of convergence and distance visual acuity with +2.00D lenses were measured in 2097 children (6–15?years) during standard school nurse screening in the municipality of Randers, Denmark. One hundred and ninety‐four children with positive screening results (near point of convergence 10?cm and/or distance visual acuity improved or maintained with +2.00D) and 182 controls with negative screening results received a full vision assessment, including cycloplegic refraction and orthoptic evaluation. Results Sensitivity and specificity of screening was 0.75 and 0.69 for CIE and 0.59 and 0.87 for hypermetropia (≥+2.00), respectively. While precision of screening for CIE was significantly higher for symptomatic children aged 9–15 than for younger and asymptomatic children, precision of screening for hypermetropia was independent of age and presence of visually related symptoms. Conclusion While precision of screening for CIE and hypermetropia (+2.00) was low, additional vision evaluation of children older than 9?years with asthenopic symptoms identified most children with CIE with a low absolute number of false positives.