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The Pediatric Vision Screener III: detection of strabismus in children
Deborah S Nassif1, Nadya V Piskun, David G Hunter
1Department of Ophthalmology, Children's Hospital Boston, Harvard Medical School, Boston, Mass 02115, USA.
Insights
The Pediatric Vision Screener (PVS) effectively identified strabismus and anisometropia in children, showing promise for early amblyopia risk detection. This tool is suitable for preschool-aged children, addressing a gap in current screening instruments.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Amblyopia, a leading cause of vision impairment in children, often stems from uncorrected refractive errors or strabismus.
- Early detection and intervention are crucial for effective amblyopia treatment.
- Existing vision screening tools may not be optimal for very young children or those in clinical settings.
Purpose of the Study:
- To assess the clinical performance of the Pediatric Vision Screener (PVS) in identifying amblyopia risk factors in a pediatric ophthalmology setting.
- To evaluate the PVS's ability to detect strabismus and anisometropia in children aged 2-18 years.
- To determine the PVS's potential as a screening instrument for preschool-aged children.
Main Methods:
- Seventy-seven children (2-18 years) underwent gold-standard orthoptic examinations.
- Subjects were classified as at risk for amblyopia if strabismus or anisometropia (>1.50 D) was present.
- The PVS was used to generate a binocularity score for pass/refer recommendations and a yield score for subject engagement.
Main Results:
- The PVS accurately identified all subjects with strabismus (constant and variable).
- Binocularity scores were significantly lower in subjects with strabismus and anisometropia compared to controls.
- The PVS identified 3 subjects with anisometropia.
Conclusions:
- The Pediatric Vision Screener demonstrates high efficacy in detecting strabismus and anisometropia in children.
- The PVS shows significant potential as a valuable screening tool in pediatric ophthalmology practices.
- This device may help overcome limitations of current screening methods for preschool-aged children.
Objective:
To evaluate the clinical performance of the Pediatric Vision Screener (PVS) in children in a pediatric ophthalmology office setting.
Methods:
Seventy-seven subjects between 2 and 18 years of age received gold-standard orthoptic examinations and were classified as at risk for amblyopia if strabismus or anisometropia (>1.50 diopters) was present. Strabismus was subclassified as variable or constant. The subjects were then tested with the PVS, which produced a pass or refer recommendation based on a binocularity score. The PVS also produced a yield score to indicate the subject's interest in the target. Sensitivity and specificity for amblyopia risk detection were calculated.
Results:
Binocularity as determined by the PVS was greater than 65% for all controls and less than 20% for all subjects with constant strabismus. Binocularity ranged from 0% to 52% in subjects with variable strabismus. All subjects with anisometropia and no strabismus had binocularity scores less than 10%.
Conclusions:
The PVS identified strabismus, when present, in all subjects and identified 3 subjects with anisometropia as well. The PVS shows potential to address a lack of screening instrumentation appropriate for use with preschool-aged children.
