In an effort to determine the sensitivity and specificity of school nurse screening for hypermetropia and convergence insufficiency exophoria (CIE) in schoolchildren, researchers found that while screening precision was low, additional vision evaluations of children older than nine with asthenopic symptoms identified most children with CIE with a low absolute number of false positives.

The study evaluated 2,097 children who underwent near point-of-convergence and distance visual acuity testing with +2.00D lenses. Of the total participants, 194 with positive screening results and 182 with negative screening results received a full vision assessment. 

The team found that the sensitivities and specificities of screening were 0.75 and 0.69 for CIE, respectively, and 0.59 and 0.87 for hypermetropia, respectively. They note that while screening precision for CIE was significantly higher for symptomatic children ages nine to 15 than for younger, asymptomatic children, screening precision for hypermetropia was independent of age and visually related symptoms.

Nisted I, Maagaard ML, Welinder L Sensitivity and specificity of in-school screening for hypermetropia and convergence insufficiency exophoria in children. Acta Ophthalmologica. December 14, 2018. [Epub ahead of print].