IMPORTANCE: The gold standard of vision screening is considered acuity testing, this article will compare the gold standard against new technology to provide more choices for pediatric vision screening programs. OBJECTIVE: To determine the reliability of recognition visual acuity screening performed by a lay screener compared to the plusoptiX A09 photoscreener for the detection of amblyopia risk factors. DESIGN: One lay screener received basic training in how to test monocular visual acuity using the 10 foot Patti Pics single crowded chart and the plusoptiX A09 photoscreener. All children underwent a complete pediatric ophthalmology examination and cycloplegic refraction after screening and this examination was the standard against which the screening method was compared. Each patient received a pass or refer grade after either screening. For the Patti Pics screening, children were referred if they failed to reach threshold visual acuity of twenty forty in either eye; the plusoptiX determines if the child is a pass or refer based on pre-set referral criteria. SETTING: Pediatric ophthalmology clinic. PARTICIPANTS: Screening was performed on children ages 3 to 10 years. RESULTS: Seventy-one children were screened. Flip chart-screening was found to have a sensitivity of 83%, specificity of 44%, false positive rate of 56% and false negative rate of 17%. Those same metrics for the plusoptiX A09 were 94%, 89%, 11% and 6%, respectively. CONCLUSION: The plusoptiX photoscreener was more sensitive and specific in making appropriate referrals for further care than flip chart-screening in this cohort of children age 3-10. The plusoptiX A09 photoscreener operated by a lay screener is a reliable method to screen for amblyopia risk factors. These finding have important implications for community based vision screening, and screening in the medical home.
IMPORTANCE: The gold standard of vision screening is considered acuity testing, this article will compare the gold standard against new technology to provide more choices for pediatric vision screening programs. OBJECTIVE: To determine the reliability of recognition visual acuity screening performed by a lay screener compared to the plusoptiX A09 photoscreener for the detection of amblyopia risk factors. DESIGN: One lay screener received basic training in how to test monocular visual acuity using the 10 foot Patti Pics single crowded chart and the plusoptiX A09 photoscreener. All children underwent a complete pediatric ophthalmology examination and cycloplegic refraction after screening and this examination was the standard against which the screening method was compared. Each patient received a pass or refer grade after either screening. For the Patti Pics screening, children were referred if they failed to reach threshold visual acuity of twenty forty in either eye; the plusoptiX determines if the child is a pass or refer based on pre-set referral criteria. SETTING: Pediatric ophthalmology clinic. PARTICIPANTS: Screening was performed on children ages 3 to 10 years. RESULTS: Seventy-one children were screened. Flip chart-screening was found to have a sensitivity of 83%, specificity of 44%, false positive rate of 56% and false negative rate of 17%. Those same metrics for the plusoptiX A09 were 94%, 89%, 11% and 6%, respectively. CONCLUSION: The plusoptiX photoscreener was more sensitive and specific in making appropriate referrals for further care than flip chart-screening in this cohort of children age 3-10. The plusoptiX A09 photoscreener operated by a lay screener is a reliable method to screen for amblyopia risk factors. These finding have important implications for community based vision screening, and screening in the medical home.
Authors: Maya Tsao Wu; M Diane Armitage; Claire Trujillo; Anna Trujillo; Laura E Arnold; Lauren Tsao Wu; Robert W Arnold Journal: BMC Ophthalmol Date: 2017-12-04 Impact factor: 2.209