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Vision screening in children by Plusoptix Vision Screener compared with gold-standard orthoptic assessment
A H Dahlmann-Noor1, K Vrotsou, V Kostakis
1Eye Treatment Centre, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St Edmunds IP33 2QZ, UK.
Insights
The Plusoptix Vision Screener (PVS) shows high specificity but moderate sensitivity for detecting amblyopia risk factors in children. This autorefractor may miss significant cases when used as a sole screening tool.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Screening Technology
Background:
- Amblyopia, or "lazy eye," is a leading cause of vision impairment in children.
- Early detection of amblyopia and its risk factors is crucial for effective intervention.
- The Plusoptix Vision Screener (PVS) is a novel autorefractor designed for pediatric vision screening.
Purpose of the Study:
- To assess the efficacy of the Plusoptix Vision Screener (PVS) in identifying amblyopia risk factors.
- To compare the PVS screening performance against established orthoptic vision screening methods.
- To evaluate the PVS's utility as a standalone screening tool for young children.
Main Methods:
- A community-based study involved 288 children aged 4-7 years.
- Children underwent screening with the PVS and comprehensive orthoptic assessments.
- Screening-positive children received follow-up examinations including manual cycloplegic retinoscopy.
Main Results:
- Both screening methods demonstrated high testability.
- Orthoptic screening identified 12.5% of children needing referral for reduced vision or amblyopia risk factors.
- The PVS identified 5.6% of children, exhibiting 44% sensitivity and 100% specificity, but underestimated refractive errors.
Conclusions:
- The Plusoptix Vision Screener (PVS) demonstrates high specificity but only moderate sensitivity in detecting amblyopia risk factors.
- Relying solely on the PVS for vision screening in young children may lead to missed diagnoses.
- Further evaluation is needed to optimize the PVS's role in pediatric vision screening programs.
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.
