A new approach to visual acuity screening for pre-school children

Abstract

The Melbourne Initial Screening Test (MIST) is a vision screening technique which combines the features of an established procedure, the five-letter Sheridan Gardiner Single (SGS) test, with a pass/fail method of assessment. It is a simple screening test for children aged 3.5-4.5 years, which is designed to be easy to use. This paper reports on the preliminary results of a comparison of threshold acuity using the 5-letter single-optotype Sheridan Gardiner (SG) test and the MIST results obtained by orthoptists, and a comparison of MIST results obtained by orthoptists and child health nurses. The orthoptists tested 225 children and the nurses tested 868 children. The MIST results obtained by the orthoptists were similar to the SGS in that there was agreement between the test results in 202 (94%) cases. The MIST has a similar rate of subject compliance (95%) as the SGS test (96%). The rate of compliance for orthoptists' and nurses' use of the MIST was similar, with 97% of children being compliant for the nurses and 96% for the orthoptists. The results suggest that the MIST, using a pass/fail method of assessing visual acuity compared to an assessment of threshold visual acuity, may be useful as part of pre-school vision screening since it is easier than the traditional testing of threshold visual acuity and gives similar results to the SG single-optotype test.