Related Experiment Video
Updated: Jun 13, 2026
Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
[PhotoScreener for preschool children visual screening]
Marcelo Mendes Lavezzo1, Roberta Lilian Fernandes de Sousa, Mayumi Shirota Kanamura
1Faculdade de Medicina de Botucatu da Universidade Estadual Paulista Júlio de Mesquita Filho - Botucatu (SP) - Brasil. mmlavezzo@yahoo.com.br
Insights
The PhotoScreener (PS) shows reasonable specificity for amblyopia screening in children, but its low sensitivity limits its effectiveness. Further research is needed to improve its diagnostic accuracy for early detection.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Amblyopia, or 'lazy eye,' is a leading cause of vision impairment in children.
- Early detection and intervention are crucial for preventing permanent vision loss.
- Current screening methods require further validation for widespread use.
Purpose of the Study:
- To assess the utility of the PhotoScreener (PS) as a screening tool for amblyopia in preschool children.
- To compare the diagnostic performance of the PS against established ophthalmologic assessment methods.
Main Methods:
- A cohort of 227 preschool children underwent screening using the PS, questionnaires, and refractometry.
- Cycloplegic refraction was performed on all participants to establish a gold standard.
- Data analysis included sensitivity, specificity, and predictive values of the PS compared to cycloplegic refraction.
Main Results:
- The PhotoScreener demonstrated a sensitivity of 50.9% and a specificity of 78.9% when compared to cycloplegic refraction.
- Positive predictive value was 70%, negative predictive value was 62.5%, and overall accuracy was 65.1%.
- Male predominance (54.6%) and an age range of 4-5 years were observed in the study population.
Conclusions:
- The PhotoScreener is a potentially useful screening method for amblyopia due to its considerable specificity.
- However, its low sensitivity indicates a significant number of false negatives, necessitating caution in its application.
- The PS may serve as a supplementary tool, but not a sole diagnostic method for identifying amblyopia in children.
Purpose:
To evaluate whether the PhotoScreener (PS) is useful as a method of screening in the prevention of amblyopia in children.
Methods:
227 preschool children were evaluated through the application of a questionnaire, refratometry measurements and photos using the PS. After this, all children were submitted to cycloplegic refraction, 30 minutes after one drop of cycloplegic agent. Refraction was performed by a mydriatic automatic refractor Shin Nippon. Children identified as suffering from eye problems were treated, according to the criteria: hyperopia greater than +1.50 D, myopia greater than -1.00 D and astigmatism greater than 1.00 D. Data were analyzed through Goodman test, descriptive statistics and study of the specificity and sensitivity of the use of PS, comparing its results with other ophthalmologic assessment methods.
Results:
There was a male predominance (54.6%), and the majority of children were four or five years old. PS sensitivity (S) compared to refraction under cycloplegia was 50.9%. The specificity (E) was 78.9%, positive predictive value (PPV) = 70%, negative predictive value (NPV) = 62.5% and accuracy (A) = 65.1%.
Conclusions:
PS, when compared to cycloplegic refraction spherical equivalent, is a reasonable method of screening, although the low sensitivity. A positive point to be emphasized is the considerable specificity.
