ABSTRACT
Aim: Our aim is to test the sensitivity and specificity of general practitioners in diagnosis of amblyopia and manifest strabismus and recommend a regular screening program in younger age such as 4-year-old in public health centers.
Methods: 1430 children were included in the study. Thirty general practitioners were trained about examination of children. Snellen E visual acuity test, Lang stereotest, Hirschberg test for manifest strabismus were performed by general practitioners in health centers. The children who were unable to pass 20/40 visual acuity, who had two line differences between eyes or who had manifest strabismus in initial examination and control subjects were referred to ophthalmologist.
Study design: Prospective double blind,
Results: One thousand seventy five of 1430 children (75.2%) were examined by general practitioners in health centers. 158 children were referred to ophthalmologist. 2.2% of children were pathologic referral. Amblyopia was diagnosed in 1.5% of them. The cause of amblyopia was refractive or anisometropia in 7 (43.75%), deprivation in 1(6.25%), strabismus in 8 (50%). The sensitivity of general practitioners was 95.8%, the specificity was 60%. False positive referral was 46.9%. The attendance rate at ophthalmologist was 57.6%. The socioeconomic status of the patients statistically determined the attendance to ophthalmologist.(p:0.029, chi-square: 2.5)
Conclusion: The Snellen visual acuity testing is practical and can be performed in public health centers by general practitioners. General practitoners could be used confidentaly in vision screening program. The socioeconomic status of subjects is a barier for attendance to ophthalmologist. Education of parents for importance of child’s eye care is mandatory.
