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Updated: May 30, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
Can a photoscreener help us remotely evaluate and manage amblyopia?
Noelle S Matta1, Robert W Arnold, Eric L Singman
1Family Eye Group, Lancaster, Pennsylvania, PA 17601, USA. noellematta@gmail.com
Introduction And Purpose:
To determine whether the plusoptiX® S04 photo-screener can assist in remotely managing amblyopia.
Methods:
A retrospective chart review was performed on 103 children with amblyopia. All patients had a plusoptiX® screening performed while wearing their optical correction during a comprehensive pediatric ophthalmology examination.
Results:
Children were classified as being fully treated in their glasses or needing further intervention to treat their amblyopia and / or strabismus. Further treatment was indicated if children were found to have abnormal alignment and / or best corrected visual acuity of 20 / 40 or worse in either eye with correction. Photoscreening results for these children demonstrated a sensitivity, specificity, false negative rate and false positive rate of 69%, 84%, 31%, and 16%, respectively. When visual acuity and photoscreening were combined for children who initially passed the plusoptiX® screen, these metrics improved to 97%, 89%, 2.7%, and 11%, respectively.
Conclusion:
Photoscreening combined with simple measurements of visual acuity may be a viable option for following efficacy of treatment in amblyopes. In some parts of the United States and in many areas of the world where telemedicine plays an increasingly important role, the plusoptiX® photoscreener could enhance vision care and may enhance telemedicine and the treatment of amblyopia.
