Vision screening in preschool children: comparison of orthoptists and clinical medical officers as primary screeners

OBJECTIVE--To see if there were differences in referral rates and abnormalities detected from two areas that were operating different preschool vision screening programmes. DESIGN--Cohort study using case notes of referrals. SETTING--Community based secondary referral centres in the county of Avon. PATIENTS--263 referrals from a child population of 7105 in Southmead district, an area that used orthoptists as primary vision screeners; 111 referrals from a child population of 2977 in Weston-super-Mare, an area that used clinical medical officers for screening. MAIN OUTCOME MEASURES--Amblyopia and squint detection rates, together with false positive referral rates. RESULTS--The amblyopia detection rate in Southmead district was significantly higher than in Weston-super-Mare (11/1000 children v 5/1000), as was the detection rate of squint (11/1000 v 3/1000). However, the false positive referral rate from Southmead was significantly lower than that from Weston-super-Mare (9/1000 v 23/1000). CONCLUSION--Preschool vision screening using orthoptists as primary screeners offers a more effective method of detecting visual abnormalities than using clinical medical officers.