[Vision saved: the first four years of the pediatric ophthalmology screening program of the Hungarian Charity Service of the Order of Malta - Part I].

Abstract

Introduction: Since 2020, the pediatric ophthalmology screening program of the Hungarian Charity Service of the Order of Malta has been providing ophthalmic care for children in disadvantaged settlements across Hungary. This study evaluates the public health impact of the program during its first four years, with a particular focus on the distribution of refractive errors and the presence of amblyogenic refractive factors. Objective: The aim of our study is to assess the operation and effectiveness of the program through the concept of “vision saved”, which encompasses interventions aimed at preventing amblyopia – such as prescribing corrective glasses, performing ophthalmic surgeries, and administering occlusion therapy. In the first part of our study, we focus on the prevalence of refractive errors and their correction. Method: Refractive error categories and distributions were determined based on data obtained using handheld video refractometers during screenings. As an indicator of screening efficiency, we analyzed referrals to optometrists, placing special emphasis on unnecessary (false alarm) referrals. Children with amblyogenic refractive errors were categorized separately in the prescription data, as timely correction can prevent the development of amblyopia in these cases. Results: Between 2020 and 2023, the screening team performed 26,410 vision screenings in 127 settlements, reaching 19,724 children. This dataset provides the first comprehensive overview of the refractive status of the Hungarian paediatric population. Among the eyes examined, 60% were emmetropic, 30.5% exhibited various forms of astigmatism, and 9.5% had pure spherical refractive errors (7.4% hyperopia; 1.87% myopia). In total, 3,985 children were referred to optometrists, corresponding to a 20% referral rate. Altogether, 2,773 pairs of spectacles were prescribed, of which 1,224 (44%) fell within the amblyogenic refractive error range and are therefore considered cases of vision saved. Discussion: The effectiveness of the screening practice improved over time, with the false alarm referral rate stabilising at 2%. The program’s sustained presence over five years has contributed to increased parental engagement and a rise in spectacle wear, which exceeded 70% by 2024. These results highlight the program’s significance. Conclusion: The pediatric ophthalmology screening program of the Hungarian Charity Service of the Order of Malta is unique in Hungary, as it provides comprehensive ophthalmic evaluation and care for disadvantaged children – from vision screening to organizing surgical interventions. Its long-term objective is to improve the quality of life of affected children through the early detection and correction of ophthalmic disorders. Orv Hetil. 2025; 166(30): 1181–1194.