Quality of vision screening in childhood

In Germany the paediatricians use three different visual acuity tests (Pictures, Rodenstock-Test, H-Test). We investigated the effectiveness of these procedures. In this study 303 children were referred by paediatricians to the study group in the Cologne Augenklinik. They were fully examined by an orthoptist and an ophthalmologist (gold standard). From these data the sensitivity and specificity of the tests used by the paediatricians were calculated. Only the H-Test proved to be satisfactory. The actual situation of screening for amblyopia by paediatricians in children aged 3 1/2 to 4 is unsatisfactory in Germany. Paediatricians and ophthalmologists should use a similar test for visual acuity. Continuing education of medical personnel is desirable to ensure an adequate quality of screening.