Validity of Vision Screener among Workers in a Private Hospital in the Northern Part of Thailand
Main Article Content
Abstract
OBJECTIVES: To assess whether results obtained by Titmus V4 occupational landolt model are valid compared to the results obtained by traditional vision tests. MATERIAL AND
METHODS: Specific tests were performed by Titmus for distance and near visual acuity, stereoacuity and color perception while traditional vision tests were performed by using 20-feet and 14-inch number snellen charts for visual acuity, Stereofly wirt dot for stereoacuity and Ishihara 38-plates for color perception.The results obtained through Titmus and those obtained through traditional vision tests were compared. Descriptive statistics, sensitivity, specificity and kappa statistics were calculated for data analysis.
RESULT: Visual performance of 220 participants mean aged 34 ± 8.6 years was obtained. Sensitivity of Titmus for distance visual acuity, near visual acuity, color perception and stereoacuity were 95.8%, 90.9%, 100% and 64.3% respectively. Specificity of Titmus for distance visual acuity, near visual acuity, color perception and stereoacuity were 64.8%, 61.7%, 100% and 68.2% respectively. Agreements of Titmus ranged from 63.2% (Near VA Both eyes) to 100% (color perception.)
CONCLUSION: Titmus proved to be a valid test for color vision deficiency. Titmus can also be used as an occupational vision screener for the assessment of distance and near visual acuity, but with poor diagnostic criteria. According to Titmus’s moderate sensitivity and specificity, Titmus is not suggested to be used for stereoacuity test. It is recommended that further clinical investigation to be undertaken for a more accurate diagnosis of the extent of abnormal visual performance among those whose tests are positive for Titmus.
Article Details
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
2. Ministerial Regulation on the Prescribing of Criteria andMethod of Conducting Health Checkup of Employees andForwarding the Results Of Health Checkup to Labour InspectorB.E. 2547 (2004).
3. Ministerial Regulation on the Prescribing of Standard forAdministration and Management of Occupational Safety,Health and Work Environment in Confined Space B.E. 2547(2004).
4. Ministry of Public Health Announcement Regarding to thePrinciple, Procedure and Condition when issued the MedicalCertificate to Demonstrate Readiness of the Seafarer On BoardB.E. 2559 (2016).
5. Summacheeva Foundation. Guideline for Standardization andInterpretation of Vision Tests in Occupational Health Setting;2016.
6. Titmus vision screener (TNO Occupational) – slides informationbrochure. Virginia: Sperian protection optical Inc., (AccessedAugust 15, 2018, at https://www.honeywellsafety.com/Supplementary/Documents_and_Downloads/Secured/Eye_and_Face_Protection/Vision_Screening/37078/1033.aspx.)
7. McAlister WH, Peters JK. The validity of Titmus vision testingresults. Mil Med 1990;155(9):396-400.
8. Health and environmental situation in Thailand. Nonthaburi:Minister of Public Health, 1997. (Accessed September 20,2018, at http://advisor.anamai.moph.go.th/main.php?filename=env105)
9. List of official ICD-10 updates ratified October 2006. Geneva:WHO, 2006. (Accessed August 15, 2018, at http://www.who.int/classifications/icd/2006Updates.pdf.)
10. Wayne W. Biostatistics - A foundations for analysis in theHealth Sciences. 6th ed. New York. Wiley & Sons;1995
11. Hassan H, Akbar F, Abbasali Y, et al. Global and regionalestimates of prevalence of refractive errors: Systematic reviewand meta-analysis. J Curr Ophthalmol 2018;30(1):3-22.
12. Holladay JT. Proper method for calculating average visualacuity. J Refract Surg 1997;13(4):388-91.
13. Stereo fly test. Chicaco: Stereo optical Co., Inc., 2017.(Accessed March 30, 2019, at https://www.stereooptical.com/wp-content/uploads/2018/01/LEA-symbols-FLY-2017-Usermanual-ONLY-12212017-2.pdf)
14. Sperian protection optical Inc. Job standards for use with theTitmus Vision Screener. Virginia: Sperian protection opticalInc.;2008.
15. Becker R, Gräf M. Landolt C and snellen e acuity:differences in strabismus amblyopia?. Klin MonblAugenheilkd 2006;223(1):24-8.
16. Latham K, Katsou MF, Rae S. Advising patients on visualfitness to drive: implications of revised DVLA regulations.Br J Ophthalmol 2015;99(4):545-8.
17. Chaikitmongkol V, Nanegrungsunk O, Patikulsila D, et al.repeatability and agreement of visual acuity using the ETDRSnumber chart, landolt C chart, or ETDRS alphabet ch art ineyes with or without sight-threatening diseases. JAMAOphthalmol 2018;136(3):286-290.
18. Moganeswari D, Thomas J, Srinivasan K, et al. Test re-testreliability and validity of different visual acuity and stereoacuitycharts used in preschool children. J Clin Diagn Res2015;9(11):NC01-5
19. Antona B, Barrio A, Sanchez I, Gonzalez E, et al. Intraexaminerrepeatability and agreement in stereoacuity measurementsmade in young adults. Int J Ophthalmol 2015;8(2):374-81.
20. Iwata Y, Tomoya H, Fusako F, et al. Effects of target size andtest distance on stereoacuity. J Ophthalmol 2016;2016:7950690.
21. Horberry T, Gale A, Taylor S. Vision screeners for displayscreen equipment users: an experimental. Displays1997;17(2):111-7.
22. Staden D, Mahomed FN, Govender S, et al. Comparing thevalidity of an online Ishihara colour vision test to thetraditional Ishihara handbook in a South African universitypopulation. Afr Vision Eye Health 2018;77(1), a370. https://doi. org/10.4102/aveh.v77i1.370.