Vision screening in children by Plusoptix Vision Screener compared with gold-standard orthoptic assessment

Br J Ophthalmol. 2009 Mar;93(3):342-5. doi: 10.1136/bjo.2008.138115. Epub 2008 Nov 19.

Abstract

Background/aims: To evaluate a new autorefractor, the Plusoptix Vision Screener (PVS), as a screening tool to detect risk factors for amblyopia by comparing it with gold-standard orthoptic vision screening in children.

Methods: Community-based screening study including 288 children age 4-7 years who were screened with the PVS and by orthoptic assessment (distance acuity, cover test, extraocular movements, 20 PD prism test, Lang stereotest). Follow-up comprehensive eye examination of screening-positive children included manual cycloplegic retinoscopy.

Results: Testability was high for both methods. Orthoptic screening identified 36 children with reduced vision and/or factors associated with amblyopia (referral rate 12.5%). The PVS identified 16 children with potential vision problems (referral rate 5.6%), indicating only moderate sensitivity (44%; 95% CI 27.9 to 61.9%), but high specificity (100%; 95% CI 98.5 to 100%) to detect factors associated with amblyopia. The PVS underestimated visually significant refractive errors.

Conclusions: Use of the PVS as single screening test in young children may miss a significant number of children with amblyopia or amblyogenic risk factors.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Amblyopia / diagnosis*
  • Child
  • Child, Preschool
  • Diagnosis, Computer-Assisted*
  • Female
  • Humans
  • Male
  • Refraction, Ocular*
  • Refractive Errors / diagnosis
  • Retinoscopes
  • Retinoscopy / methods
  • Sensitivity and Specificity
  • Video Recording
  • Vision Tests
  • Visual Acuity