• Mladen Bušić, Mirjana Bjeloš, Mladen Petrovečki, Biljana Kuzmanović Elabjer, Damir Bosnar, Senad Ramić, Daliborka Miletić, Lidija Andrijašević, Edita Kondža Krstonijević, Vid Jakovljević, Ana Bišćan Tvrdi, Jurica Predović, Antonio Kokot, Filip Bišćan, Mirna Kovačević Ljubić, and Ranka Motušić Aras.
• Mirjana Bjeloš, University Eye Clinic, University Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia, mbjelos@mef.hr.
• Croat. Med. J. 2016 Feb 1; 57 (1): 29-41.

AimTo present and evaluate a new screening protocol for amblyopia in preschool children.MethodsZagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic.Results78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively.ConclusionThe ZAPS study used the most discriminative VA test with optotypes in line as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.

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