Stereoacuity in preschool children – could the Randot stereotestbe the screening test to prevent amblyopia?
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Students’ Scientific Society, Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia in Katowice
Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia in Katowice
Anita Muskalska   

Students’ Scientific Society, Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia in Katowice, ul. Ceglana 35, 40-514 Katowice
Ann. Acad. Med. Siles. 2019;73:194–198
Amblyopia in the preschool age may lead to abnormal psychomotor development. It may result from binocular visual disorders (anisometropia, vision defects, strabismus, cataract, others) and leads to a lack of stereoscopic vision or to reduced stereoacuity in adulthood. Early detection of amblyopia can provide a chance for treatment to improve vision and for appropriate development of the child.

Material and methods:
The examination was performed using the Randot stereotest and a set of wooden blocks. 412 girls and 398 boys in the age range of 3 to 7 years were examined. In the case of a lack of stereoscopic vision, the children were referred for an ophthalmological examination. Analyses were performed using the Cochran-Armitage and Jonckheere-Terpstry tests for trend in MedCalc and SPSS 17.0 software.

Stereoacuity was not found in 18 (2.2%) children. Most of the examined children had a stereoacuity level of 100 seconds of arc: 76% of the 3-year-old children, 46% of the 4-year-old children and 60% of the 5-year-old children. Among the older children the highest percentage reached the stereoacuity level of 70 seconds of arc. The level of stereopsis increases with age statistically significantly. Binocular amblyopia caused by refractive errors was found in children in whom stereopsis was not found.

The Randot stereotest turned out to be an effective tool in detecting binocular vision disorders in preschool children. The authors suggest implementing the Randot stereotest to complement the screening program to detect amblyopia in preschool children.

Ciner E.B., Ying G., Kulp M.T., Maguire M.G., Quinn G.E., Orel-Bixler D., Cyert L.A., Moore B., Huang J. Stereoacuity of Preschool Children with and without Vision Disorders. Optom. Vis. Sci. 2014; 91(3): 351–358, doi: 10.1097/OPX.0000000000000165.
Schmidt P.P., Maguire M.G., Moore B., Cyert L. Testability of preschoolers on stereotests used to screen vision disorders. Optom. Vis. Sci. 2003; 80(11): 753–757, doi: 10.1097/00006324-200311000-00012.
Afsari S., Rose K.A., Pai A.S., Gole G.A., Leone J.F., Burlutsky G., Mitchell P. Diagnostic reliability and normative values of stereoacuity tests in preschool-aged children. Br. J. Ophthalmol. 2013; 97(3): 308–313, doi: 10.1136/bjophthalmol-2012-302192.
Nelson H., Nygren P., Huffman L., Wheeler D., Hamilton A. Screening for visual impairment in children younger than Age 5 years: update of the evidence from randomized controlled trials, 1999–2003. Agency for Healthcare Research and Quality, Rockville, MD. 2004, doi: 10.1370/afm.193.
Thompson J.R., Woodruff G., Hiscox F.A., Strong N., Minshull C. The incidence and prevalence of amblyopia detected in childhood. Public Health, 1991; 105(6): 455–462, doi: 10.1016/S0033-3506(05)80616-X.
Packwood E.A., Cruz O.A., Rychwalski P.J., Keech R.V. The psychosocial effects of amblyopia study. JAAPOS 1999; 3(1): 15–17, doi: 10.1016/S1091-8531(99)70089-3.
Chua B., Mitchell P. Consequences of amblyopia on education, occupation, and long term vision loss. Br. J. Ophthalmol. 2004; 88(9): 1119–1121, doi: 10.1136/bjo.2004.041863.
Krueger D.E., Ederer F. Report on the National Eye Institute’s Visual Acuity Impairment Survey Pilot Study. Office of Biometry and Epidemiology. National Institutes of Health, Public Health Services. Department of Health and Human Services Bethesda 1984.
Tomaç S., Altay Y. Near stereoacuity: development in preschool children; normative values and screening for binocular vision abnormalities, a study of 115 children. Binocul. Vis. Strabismus Q. 2000; 15(3): 221–228. PMID: 10960225.
Tarczy-Hornoch K., Lin J., Deneen J., Cotter S.A., Azen S.P., Borchert M.S., Wang Y., Varma R. Stereoacuity testability in African-American and Hispanic preschool children. Optom. Vis. Sci. 2008; 85(3): 158–163, doi: 10.1097/OPX.0b013e3181643ea7.
Trager M.J., Dirani M., Fan Q., Gazzard G., Selvaraj P., Chia A., Wong T.Y., Young T.L., Varma R., Saw S.M. Testability of vision and refraction in preschoolers: the strabismus, amblyopia, and refractive error study in Singaporean children. Am. J. Ophthalmol. 2009; 148(2): 235–241, doi: 10.1016/j.ajo.2009.02.037.
Riordan-Eva P., Whitcher J.P. Specjalne zagadnienia z zakresu okulistyki dziecięcej. W: Okulistyka Vaughana i Ausbury’ego. Red. E. Wylęgała. Czelej, Lublin 2011; s. 355.
Screening for Visual Impairment in Children Younger Than Age 5 Years: Recommendation Statement. Ann. Fam. Med. 2004; 2(3): 263–266.