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The children completed a vision screening and a full eye examination. The vision screening consisted of visual acuity at distance (<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>), visual acuity at distance with +2.0 glasses (<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>+2), visual acuity at near (<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>near) and Lang <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> stereotest. A Log<jats:styled-content style=\"fixed-case\">MAR<\/jats:styled-content>\u2010based picture chart was used for the vision testing. Significant refractive errors were defined as hyperopia \u2265+3.5\u00a0D, myopia &gt;1.0\u00a0D, astigmatism \u22651.25\u00a0D and anisometropia &gt;1.0\u00a0D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using receiver operating characteristic (ROC) curves, we could compare the efficiency of <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> VA<\/jats:styled-content>+2, <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>near, <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> in combination with <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>+2 and <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> in combination with <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>near. Area under the curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) for <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> VA<\/jats:styled-content> combined with <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>+2 and <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> combined with <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>near was 0.841, 0.857 and 0.857, respectively, that is all classified as \u2018very good\u2019 screening tools, whereas <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>+2 and <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>near as single screening tools were classified as \u2018good\u2019 with <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 0.704 and 0.775, respectively. Using the optimal cut\u2010off limit from the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curves, <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> above 0.05 Log<jats:styled-content style=\"fixed-case\">MAR<\/jats:styled-content> as cut\u2010off limit showed a sensitivity of 85.2% with a specificity of 74.9%. A slightly higher sensitivity could be found when combining screening tests, but with declining specificities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Visual acuity at distance with the use of Log<jats:styled-content style=\"fixed-case\">MAR<\/jats:styled-content>\u2010based charts is the optimal screening tool of choice; only minor improvements can be obtained combining with other tests.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13922","type":"journal-article","created":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T12:57:27Z","timestamp":1537102647000},"page":"473-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Analysis of the current preschool vision screening in 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