Comparing a traditional single optotype visual acuity test with a computer-based visual acuity test for childhood...

Area of Science:

• Ophthalmology
• Pediatric Vision Screening
• Diagnostic Technology Evaluation

Background:

• Traditional vision screening methods like the Sheridan Gardiner test (SGT) are widely used but may have limitations in detecting certain visual impairments.
• Computer-based tests (CBTs) offer potential advantages in standardization, engagement, and data collection for vision screening.

Purpose of the Study:

• To compare the effectiveness of a computer-based test (LazyeyeTest.org) against the Sheridan Gardiner test (SGT) for measuring visual acuity and detecting amblyopia in children.
• To evaluate the usability and efficiency of both vision screening methods.

Main Methods:

• A prospective, masked, cross-over study was conducted with kindergarten-aged children.
• Visual acuity was measured monocularly using both the SGT and LazyeyeTest.org.
• Referral rates, referral outcomes, and usability were compared between the two tests.

Main Results:

• The computer-based test (CBT) resulted in more low visual acuity scores, likely due to crowding bars on its optotypes.
• The CBT referred more children for further evaluation, with two cases of amblyopia identified among those referred.
• The CBT demonstrated higher sensitivity (88%) and specificity (92%) compared to the SGT, and was preferred by children and screeners for ease of use and engagement.

Conclusions:

• Replacing the SGT with LazyeyeTest.org could enhance the efficiency and sensitivity of amblyopia screening programs.
• Further research is recommended to validate these findings and assess the accuracy of lay screeners using the CBT.