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  1. Abdul Rahman SNA, Naing NN, Othman AM, Mohamad Z, Ibrahim TMM, Hashim SE, et al.
    Medicina (Kaunas), 2023 May 10;59(5).
    PMID: 37241144 DOI: 10.3390/medicina59050912
    Background and Objectives: The health-related mobile applications (app) might assist in promoting inclusive health and tele-treatment, especially for the less severe diseases. In this paper, a study had been done to determine the app's reliability in terms of raters and the app's agreement with the Snellen chart. Materials and Methods: A cross-sectional sectional study was conducted between November 2019 and September 2020. Participants were selected via purposive sampling from selected communities in Terengganu state. All participants underwent vision testing with the Vis-Screen app and Snellen chart for validity and reliability accordingly. Results: A total of 408 participants were involved, with a mean age of 29.3. The sensitivity of the presenting vision of the right eye (PVR) ranged from 55.6% to 88.4%, with specificity between 94.7% to 99.3%, while the positive and negative predictive values were between 57.9% and 81.7% and 96.8% and 99.0%, respectively. The positive likelihood ratios ranged between 16.73 and 73.89, whereas the negative likelihood ratios ranged from 0.12 to 0.45. The area under the receiver operating characteristic curve (AUC) for all cut-off points ranged between 0.93 and 0.97, and the optimum cut-off point was at 6/12. The kappa values for intra-rater and inter-rater were 0.85 and 0.75, respectively, while the app's reliability with the Snellen chart was 0.61. Conclusions: Vis-Screen was concluded to be valid and reliable for use as a screening tool for detecting individuals with visual impairment and blindness in the community. A valid and reliable portable vision screener like Vis-Screen will help expand the eye care feasibility while providing similar accuracy as the conventional charts in clinical practices.
    Matched MeSH terms: Vision Screening*
  2. Omar R, Hussin DA, Knight VF
    J Med Assoc Thai, 2012 Mar;95(3):412-7.
    PMID: 22550841
    Compare the performance of Lea Symbols and Sheridan Gardiner charts against the standard test chart used to determine reduced VA during vision screening among pre-schoolers.
    Matched MeSH terms: Vision Screening/methods*
  3. Norhani Mohidin, Saadah Mohd Akhir, Bariah Mohd Ali, Zainora Mohammed, Sharanjeet, K., Chung, K.M.
    MyJurnal
    A vision screening study was carried out among Indian schoolchildren around Kuala Lumpur to determine whether the prevalence of myopia was higher in boys or girls. Altogether 749 students (49.7% boys and 50.3% girls) aged 7-18 years were screened and their refractive error examined using retinoscopy without cycloplegia. For the right eye 15.1% of the girls' eyes were found to be myopic as compared to 16.9% of the boys, of which chi-square showed no significant difference (p = 0.44). For the left eye 18.8% of the girls' eyes were myopic as compared to 16.4% of the boys. Chi square also showed no significant difference (p = 0.26). When high myopia (> -6.00D) was considered, there was no difference found between boys and girls. The number of students with high myopia greater than -6.00D was also very small (0.3%-0.5%). In conclusion, it was found that there was no significant difference in myopia between girls and boys among Indian schoolchildren.
    Matched MeSH terms: Vision Screening
  4. Nurul Farhana, A.B., Chen, A.H., Abdul Rahim, M.N., Goh, P.P.
    MyJurnal
    Introduction: School vision screening program is a scheduled program under the Ministry of Health, Malaysia for 7, 12 and 15 years-old children in the government schools. The aim of this study was to review the school vision screening program from the perspective of the personnel involved as the screener. Methods: The evaluation of the performance of the screener was based upon the accurate referrals' outcome from the school health database of Betong Division in Sarawak, Malaysia in the year of 2008. Results: The total accuracy of the referrals was 50.7%. Lower accuracy of the referrals was found significantly associated with Grade 1 [χ2 (2.N=304) = 28.810, p
    Matched MeSH terms: Vision Screening
  5. Nurul Farhana Abu Bakar, Ai-Hong Chen
    MyJurnal
    The purpose of this study is to assess the performance of allied health personnel, after attending a training programme, in conducting vision screening for preschool children. A total of 43 allied health personnel (20 assistant medical officers (AMOs) and 23 nurses) attended a two-day training program prior to conducting vision screening for preschool children. Vision screening was conducted among 136 preschool children using four similar HOTV visual acuity chart at 6 m. The cut-off referral criterion for visual acuity (VA) testing was 6/9 or worse in either eye. All children were referred to two qualified optometrists for a comprehensive eye examination. The accuracy was based on the sensitivity and specificity of screening by each group of personnel. The overall prevalence of reduced VA in the studied population was about 10%. The sensitivity and specificity of vision screening performed by AMOs were 100% and 98% respectively while that performed by nurses were 56% and 94% respectively. Thus, there were discrepancies in the sensitivity of visual acuity testing despite them being conducted by healthcare providers with similar background and training. This suggests that their performance might be influenced by factors other than their professional training.
    Matched MeSH terms: Vision Screening
  6. Omar, R., Knight, V.F., Tan, X.L., Ahmad Zahidi A.A., Mohd Saat, N.Z.
    JUMMEC, 2019;22(1):58-65.
    MyJurnal
    Empowering lay screeners, such as pre-school teachers, on vision screening is a cost-effective way to
    ensure larger populations of children can be screened. Although the validity of lay screeners in conducting
    vision screening were reported in several studies, none showed data concerning improvement of the level
    of knowledge among lay screeners after completing vision screening training, which could indicate the
    effectiveness of the training program. This study aimed to determine the level of knowledge of pre-school
    teachers before and after attending a training program. Sixty pre-school teachers from Tabika and Taska KEMAS
    were randomly selected. The Study Group (n = 30) was given theory and practical training on vision screening,
    whereas the Control Group (n = 30) was only given brief verbal instructions on how to conduct the screening. A
    theory test containing 15 questions related to the training modules were administered to both groups, before
    and after their training/briefing respectively. The findings showed that the level of knowledge among preschool
    teachers in the Study Group (73.24 ± 11.73%) was significantly higher than the Control Group (56.22
    ± 13.11%) (p < 0.01). There was also a significant improvement in the level of knowledge among pre-school
    teachers in the Study Group after the training (p
    Matched MeSH terms: Vision Screening
  7. Abu Bakar NF, Chen AH
    Indian J Ophthalmol, 2014 Feb;62(2):141-4.
    PMID: 24008790 DOI: 10.4103/0301-4738.116481
    Children with learning disabilities might have difficulties to communicate effectively and give reliable responses as required in various visual function testing procedures.
    Matched MeSH terms: Vision Screening/methods*
  8. Abu Bakar NF, Chen AH, Md Noor AR, Goh PP
    Singapore Med J, 2012 Aug;53(8):541-4.
    PMID: 22941133
    The visual status of children with learning disabilities has not been extensively studied. This study aimed to compare vision disorders between children in mainstream classes and those with learning disabilities attending special education classes in government primary schools in Malaysia.
    Matched MeSH terms: Vision Screening/methods*
  9. Premsenthil M, Manju R, Thanaraj A, Rahman SA, Kah TA
    BMC Ophthalmol, 2013 Apr 19;13:16.
    PMID: 23601160 DOI: 10.1186/1471-2415-13-16
    BACKGROUND: To screen for visual impairment in Malaysian preschool children.

    METHODS: Visual screening was conducted in 400 preschool children aged 4 to 6 years. The screening involved two basic procedures; the distant visual acuity test using the Sheridan Gardiner chart and the depth perception test using the Langs stereoacuity test. Criteria for referral were a visual acuity of 6/12 or less in the better eye or a fail in the depth perception test.

    RESULTS: The prevalence of visual impairment was 5% (95% confidence interval [CI] = 3.3, 7.6). Of the 400 preschool children screened, 20 of them failed the distant visual acuity test or the stereopsis test. Refractive errors were the most common cause of visual impairment (95%, 95% CI = 76.2, 98.8); myopic astigmatism was the commonest type of refractive error (63.2%, 95% CI = 40.8, 80.9).

    CONCLUSION: The study is a small but important step in the effort to understand the problem of visual impairment among our preschool children. Our study showed that it is feasible to measure distant visual acuity and stereopsis in this age group.

    Matched MeSH terms: Vision Screening/methods*
  10. Ting SL, Lim LT, Ooi CY, Rahman MM
    Asia Pac J Ophthalmol (Phila), 2019;8(3):229-232.
    PMID: 31165604 DOI: 10.22608/APO.2018433
    PURPOSE: To compare the measurement of intraocular pressure (IOP) of Icare rebound tonometer and Perkins applanation tonometer (PAT) during community eye screening and to assess the agreement between these 2 instruments.

    DESIGN: A cross-sectional, non-interventional study.

    METHODS: The IOP measurements by handheld Icare rebound tonometer (Finland) were first performed by a primary care physician. Then the IOP was measured using Perkins Mk3 applanation tonometer (Haag-Streit, UK) by an ophthalmologist who was masked to previous readings from the Icare rebound tonometer. The mean IOP measured by each tonometer was compared. Pearson correlation coefficient was used to explore the correlation between the IOP measurements of the 2 instruments. The level of agreement between them was assessed using the Bland and Altman method.

    RESULTS: A total of 420 left eyes were examined. The mean age of subjects was 38.6 ± 18.2 years. Approximately 67% of subjects were female. The mean IOP was 16.3 ± 4.0 mm Hg using Icare and 13.4 ± 2.3 mm Hg using PAT. Pearson correlation coefficient showed a moderate positive correlation between the 2 methods (r = +0.524, P < 0.001). Linear regression analysis revealed a slope of 0.28 with R² of 0.255. The mean difference between the 2 methods was 2.90 ± 3.5 mm Hg and the sample t-test revealed a statistically significant mean difference from 0 (P < 0.001). The 95% limits of agreement between the 2 methods were between -9.73 and 3.93 mm Hg.

    CONCLUSIONS: The handheld Icare rebound tonometer is a reasonably acceptable screening tool in community practices. However, Icare overestimated IOP with a mean of 2.90 mm Hg higher than the PAT. Thus, using Goldmann applanation tonometer as a confirmatory measurement tool of IOP is suggested.

    Matched MeSH terms: Vision Screening/methods*
  11. Nik Azis NN, Chew FLM, Rosland SF, Ramlee A, Che-Hamzah J
    J AAPOS, 2019 10;23(5):268.e1-268.e6.
    PMID: 31520719 DOI: 10.1016/j.jaapos.2019.01.019
    PURPOSE: To evaluate parents' performance in using the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) Vision Screening App (application) as a vision screening tool among preschool children and to evaluate the reliability of this app.

    METHODS: A total of 195 5- and 6-year-old preschoolers were recruited from children attending Hospital Selayang, Selangor, Malaysia, to test the app. Uncooperative children and those with visual acuity of >logMAR 0.6 were excluded. Results from parents and the screening doctor using the app (Lea symbols) to test visual acuity were compared to each other and to gold standard vision testing by an optometrist using the Lea symbols chart.

    RESULTS: Children 5 years of age represented 46.7% of the study population. The mean age of parents was 37.27 ± 7.68 years. Bland-Altman scatterplot agreement between assessors mainly was within the 95% confidence interval for bilateral eyes screening. Parents obtained a sensitivity of 86.6% (right vision) and 79.5% (left vision) and specificity of 78.9% (right vision) and 71.8% (left vision). Parents took a mean of 191.2 ± 70.82 seconds for bilateral screening. The intraclass correlation coefficient between optometrist and parents in bilateral eyes screening was good (P 0.7, indicating high internal reliability of the app. Most parents (178/195 [91.3%]) strongly agreed on the app's acceptability and ease of use.

    CONCLUSIONS: The AAPOS Vision Screening App used by parents is a promising tool for visual acuity screening among Malaysian preschool children and a reliable app for vision screening.

    Matched MeSH terms: Vision Screening/instrumentation*
  12. Chung KM, Mohidin N, Yeow PT, Tan LL, O'Leary D
    Optom Vis Sci, 1996 Nov;73(11):695-700.
    PMID: 8950751
    We performed a vision screening of 1883 Chinese schoolchildren from 4 schools around Kuala Lumpur in June 1990. The group contained 1083-males and 800 females. Visual acuity, refractive error, oculomotor balance, and axial length were measured. The prevalence of myopia in Chinese schoolchildren was found to be 37% in the 6- to 12-year age group and 50% in the 13- to 18-year age group. Approximately 63% of the sample had unaided visual acuity of 6/6 or better and 24% had unaided acuity of 6/12 or worse. Six hundred twenty-five students (33%) failed the vision screening test and were referred for further examinations. The group which failed the vision screening test and had the highest rate of referral (46%) was the 11- to 12-year-old age group. The most common visual disorder was uncorrected myopia, accounting for 38% of the referrals (235 students). Only 26% of the sample were wearing a spectacle correction.
    Matched MeSH terms: Vision Screening
  13. Linggam, Rachel Clarice, Arifah Nur Bt Yahya, Muhassanah Aliah Bt Baharum
    MyJurnal
    Introduction: Vision is an important requirement for learning and plays a critical role in the development of a child during the first three years of life. Little is known regarding the extent of visual impairment amongst preschool children in Sabah.
    Objective: To determine visual status among preschool children in Kota Kinabalu and to determine prevalence of refractive error among children who were referred by the programme.
    Methodology: A retrospective cohort study of clinical records was conducted at Department of Ophthalmology, Hospital Queen Elizabeth, Kota Kinabalu, Sabah from May to September 2017. Criteria for failed vision were VA 6/12 (0.3 LogMar) or worse. All records of referred children were selected for prevalence of refractive error. Data collected include basic demographic data, visual acuity and refractive error. Myopia was defined as spherical equivalent (SE) ≥−1.00 DS, hyperopia SE ≥+3.00 DS and astigmatism ≥−1.50 DC.
    Results: A total of 192 children age 4 to 6 years old were screened, comprised of 102 (53.1%) male and 90 (46.9%) female (mean age: 5.81 ± 0.41 years). Of the 192 students, 39 (20.3%) of them failed vision screening. Among the 39 children, only 17 children came for further eye assessment. Twelve (70.6%) of them had a binocular visual impairment (VI) while 5 (29.4%) children had monocular VI. Six years old children were found to have VI more compared to other age groups (n= 14, 82.4%) and majority of this age group having binocular VI (n=10, 83.3%). Mean SE was −0.60 ± 0.94. Astigmatism is the commonest type of refractive error found with a prevalence of 41.4% followed by myopia, 27.6%.
    Conclusion: This study was the first attempt to investigate the visual status among preschool in Kota Kinabalu. As most children were found with astigmatism, early detection of significant refractive error could help to minimize the effect of VI.
    Matched MeSH terms: Vision Screening
  14. Yahya AN, Sharanjeet-Kaur S, Akhir SM
    PMID: 31783494 DOI: 10.3390/ijerph16234730
    Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.
    Matched MeSH terms: Vision Screening
  15. Chew FLM, Thavaratnam LK, Shukor INC, Ramasamy S, Rahmat J, Reidpath DD, et al.
    Med J Malaysia, 2018 02;73(1):25-30.
    PMID: 29531199 MyJurnal
    INTRODUCTION: Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia.

    OBJECTIVE: To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children.

    METHODOLOGY: A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria.

    RESULTS: A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia.

    CONCLUSION: Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.

    Matched MeSH terms: Vision Screening
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