Vision Screening for the Detection of Amblyopia

Study Overview
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Brief Summary
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INTRODUCTION. Amblyopia is defined as the loss of visual acuity (VA) in one or both eyes, without any obvious structural or pathological anomalies. Amblyopic eye should be able to regain some VA if treatment is initiated before the age of seven. It is the leading cause of monocular blindness in the 20- to 70-year olds with prevalence 2-5%. Amblyopia is mainly monocular, hence children are general asymptomatic. VA testing is the only reliable method of detecting amblyopia, and the fourth year of life is considered best for vision screening programs. AIM: The purpose of the study is to reduce the preventable vision loss. The main goal of the study is to evidence the problem of amblyopia in Zagreb and to release a model for formal, government directed vision-screening program as a Croatian public health policy. HYPOTHESIS. In Croatia, the prevalence and actual effect of amblyopia and amblyogenic factors, along with treatment efficacy is impossible to quantify, since no population-based studies have been performed regarding this issue. In addition, national screening of preschool children does not exist, while the school-entry screening is prescribed by law. The object of the study is to determine the prevalence of amblyopia in a 4-4.5 year old children of The Town of Zagreb, the efficacy of screening and effectiveness of treatment on reducing amblyopia prevalence. The primary hypothesis is defined: screening of visual acuity monocularly at distance and near in 4-4.5 year old children in Zagreb is effective in detecting amblyopia. PATIENTS AND METHODS: Monocular vision of about 7000 children/ year aged 4-4.5 for whom both parents gave consent is to be tested with Lea chart at near (40cm) and distance (3m) in the kindergartens of The Town of Zagreb. The criterion for referral to complete ophthalmological examination is VA <0.8.

Official Title
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Vision Screening of the Four Year Old Children for the Detection of Amblyopia in The Town of Zagreb

Conditions
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Amblyopia, Refractive Errors, Anisometropia, Strabismus, Ptosis

Intervention / Treatment
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* Other: Amblyopia screening


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children in the kindergartens of The Town of Zagreb aged 4-4.5 for whom both parents gave written informed consent Exclusion Criteria: children younger than 4 years and children older than 4.5 years

Ages Eligible for Study
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Minimum Age: 48 Months
Maximum Age: 54 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Amblyopia screening<br> | Other: Amblyopia screening<br>* Monocular vision testing at near (40cm) and distance (3m)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| prevalence of amblyopia | proportion of children with amblyopia in a total population of children screened | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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amblyopia, amblyogenic factors, screening, preschool children, visual acuity, prevalence