{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:28:34Z","timestamp":1771460914779,"version":"3.50.1"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["16\/521"],"award-info":[{"award-number":["16\/521"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Preschool children in New Zealand undergo vision screening to detect amblyopia at 4\u20135\u00a0years of age. The current test, the Parr vision test, does not meet international visual acuity chart guidelines and has not been validated against other commonly used paediatric vision tests. New Zealand vision screening protocols are also not targeted for detecting other eye conditions such as uncorrected refractive error, which may affect school performance. We compared the Parr vision test with the single crowded Lea symbols and the Spot vision screener for detecting ocular pathology, refractive error and amblyopic risk factors in preschool children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional diagnostic accuracy study recruited children aged 4\u20135\u00a0years via convenience sampling from the University of Auckland Optometry Clinic and through primary schools in Auckland, New Zealand. Participants received vision screening with the three different instruments administered by a lay screener. Comprehensive eye examinations were completed by a paediatric optometrist to determine the presence of vision disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 197 children who received a comprehensive eye examination, 14 (7.1%) had amblyopic risk factors and 43 (21.8%) had significant refractive error (15.7% with astigmatism, 9.1% with hyperopia). The sensitivity for detecting any ocular condition did not differ significantly between the tests (50.0% for Parr, 43.5% for Lea, 42.5% for Spot). Specificity was significantly lower for the Parr vision test (80.8%) than for the Lea symbols (93.4%) and Spot vision screener (98.0%). Adding the Spot vision screener to measurements of visual acuity significantly improved sensitivity in detecting any ocular condition with the Parr vision test (67.5% for Parr\/Spot vs 50% for Parr alone), but not with the Lea symbols (52.5% for Lea\/Spot vs 43.5% for Lea alone).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The sensitivity of the Parr vision test for detecting ocular conditions in preschool children does not vary significantly from that achieved by the Lea symbols or the Spot vision screener. However, current New Zealand vision screening protocols could be improved by expanding the target conditions to include significant refractive error and incorporating the use of the Spot vision screener to increase the accuracy with which children with refractive error are identified. Future research should include longitudinal studies to determine the effect of preschool vision screening on later ocular and academic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.12816","type":"journal-article","created":{"date-parts":[[2021,4,4]],"date-time":"2021-04-04T01:38:31Z","timestamp":1617500311000},"page":"541-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnostic accuracy of the Parr vision test, single crowded Lea symbols and Spot vision screener for vision screening of preschool children aged 4\u20135\u00a0years in Aotearoa\/New Zealand"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6219-7625","authenticated-orcid":false,"given":"Rebecca","family":"Findlay","sequence":"first","affiliation":[{"name":"School of Optometry and Vision Science University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Black","sequence":"additional","affiliation":[{"name":"School of Optometry and Vision Science University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Goodman","sequence":"additional","affiliation":[{"name":"School of Optometry and Vision Science University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Chelimo","sequence":"additional","affiliation":[{"name":"Department of Paediatrics \u2010 Child and Youth Health School of Medicine University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron C","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Paediatrics \u2010 Child and Youth Health School of Medicine University of Auckland  Auckland New Zealand"},{"name":"General Paediatrics Starship Children's Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1999-5274","authenticated-orcid":false,"given":"Nicola","family":"Anstice","sequence":"additional","affiliation":[{"name":"School of Optometry and Vision Science University of Auckland  Auckland New Zealand"},{"name":"Caring Futures Institute College of Nursing and Health Science Flinders University  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,3]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Well Child \/ Tamariki Ora Programme Practitioner Handbook: Supporting Families and Wh\u0101nau to Promote their Child's Health and Development","author":"Ministry of Health","year":"2014"},{"key":"e_1_2_8_3_1","first-page":"157","article-title":"Clinical assessment of visual acuity","volume":"33","author":"Parr JC","year":"1981","journal-title":"Trans Ophthalmol Soc N Z"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5701.108"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000000863"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2007.134841"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.9900"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.179"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/cxo.12953"},{"key":"e_1_2_8_10_1","first-page":"681","article-title":"Uncorrected hyperopia and preschool early literacy: results of the Vision in Preschoolers\u2010Hyperopia in Preschoolers (VIP\u2010HIP) study","volume":"123","author":"Vision in Preschoolers \u2010 Hyperopia in Preschoolers (VIP \u2010 HIP) Study Group","year":"2016","journal-title":"Ophthalmology"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000000779"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2010.134"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/09286580903450320"},{"key":"e_1_2_8_14_1","first-page":"33","article-title":"The prevalence of refractive error and visual impairment among New Zealand children in a community with significant socioeconomic disadvantage: is current preschool vision screening effective?","volume":"133","author":"Findlay R","year":"2020","journal-title":"N Z Med J"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000000429"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000001505"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2015.09.003"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-0141"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cxo.12086"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.1980.tb08291.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181c750b1"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-6391"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3999"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.11648\/j.ajtas.20160501.11"},{"key":"e_1_2_8_25_1","unstructured":"Statistics New Zealand.Ethnicity standard classification 2005 http:\/\/infoshare.stats.govt.nz\/methods\/classifications\u2010and\u2010standards\/classification\u2010related\u2010stats\u2010standards\/ethnicity.aspx#gsc.tab=0(Accessed 21\/03\/21)."},{"key":"e_1_2_8_26_1","volume-title":"Ethnicity Data Protocols for the Health and Disability Sector","author":"Ministry of Health","year":"2004"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2004.01.022"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(01)01256-9"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.06-0384"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009207"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/pam.22043"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170839"},{"key":"e_1_2_8_34_1","volume-title":"The Social Report","author":"Ministry of Social Development","year":"2016"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68581-4"},{"key":"e_1_2_8_36_1","first-page":"917","article-title":"Comparison of preschool vision screening methods in a population with a high prevalence of astigmatism","volume":"42","author":"Miller JM","year":"2001","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_8_37_1","first-page":"250","article-title":"Importance of including refractive error tests in school children's vision screening","volume":"14","author":"Fotouhi A","year":"2011","journal-title":"Arch Iran Med"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969141315572403"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/cxo.12029"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032138"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.02-1199"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2011.333"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/2576117X.2019.1618690"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)73474-9"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.opx.0000144746.80718.67"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-200107000-00017"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12387"},{"key":"e_1_2_8_48_1","volume-title":"Interior and Workplace Lighting. Specific Applications \u2010 Educational and Training Facilities (AS\/NZS 1680.2.3)","author":"Standards Australia\/Standards New Zealand","year":"2008"},{"key":"e_1_2_8_49_1","volume-title":"New Zealand Health Strategy: Future direction","author":"Minister of Health","year":"2016"},{"key":"e_1_2_8_50_1","first-page":"3","volume-title":"Hauora: M\u0101ori Standards of Health IV A study of the years 2000\u20102005","author":"Reid P","year":"2007"},{"key":"e_1_2_8_51_1","first-page":"63","article-title":"Vision screening in New Zealand: an audit of the B4 School Check","volume":"132","author":"Muller W","year":"2019","journal-title":"N Z Med J"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-009-1150-2"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(99)00455-9"}],"container-title":["Ophthalmic and Physiological Optics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/opo.12816","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/opo.12816","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/opo.12816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:26:01Z","timestamp":1767785161000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/opo.12816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,3]]},"references-count":52,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1111\/opo.12816"],"URL":"https:\/\/doi.org\/10.1111\/opo.12816","archive":["Portico"],"relation":{},"ISSN":["0275-5408","1475-1313"],"issn-type":[{"value":"0275-5408","type":"print"},{"value":"1475-1313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,3]]},"assertion":[{"value":"2020-09-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}