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Related Experiment Video

Updated: Dec 10, 2025

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Traditional and instrument-based vision screening in third-grade students.

Evan Silverstein1, Elaine R McElhinny2

  • 1Department of Ophthalmology, Virginia Commonwealth University, Richmond, Virginia.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|August 31, 2020
PubMed
Summary

Instrument-based vision screening is as effective as traditional methods for third graders and significantly faster. This approach offers a time-efficient alternative for school-based vision assessments.

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Area of Science:

  • Pediatric Ophthalmology
  • Vision Science
  • Public Health

Background:

  • Traditional optotype vision screening is recommended for children over 5.
  • Instrument-based screening is more time-efficient for younger children (3-4 years).
  • This study directly compares instrument-based and traditional screening in third graders.

Purpose of the Study:

  • To compare instrument-based vision screening with traditional optotype screening in a school setting.
  • To evaluate the effectiveness and time efficiency of different vision screening methods for third graders.

Main Methods:

  • Third graders (n=1,593) from 16 schools underwent screening using traditional methods (optotypes, stereoacuity) and a photoscreener (Plusoptix S12).
  • Referred children were offered comprehensive eye exams with cycloplegic refraction.

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  • Screening time was recorded for both methods.

    • Main Results:

    • No statistical difference was found between methods in detecting visual acuity <20/30 or the need for intervention.
    • Photoscreening referred 398 children, traditional screening referred 287, with 169 referred by both.
    • Instrument-based screening averaged 30 seconds per child, while traditional screening averaged 120 seconds.

    Conclusions:

    • Instrument-based and traditional screening show similar positive predictive values for detecting the need for glasses in third graders.
    • Instrument-based vision screening is significantly more time-efficient than traditional methods in a school-based setting.