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A Comparative Study of Two Photoscreening Devices With Manual Vision Screening Involving Preschool Children.

David C Musch, Chris A Andrews, Rachel A Schumann

    Journal of Pediatric Ophthalmology and Strabismus
    |August 26, 2021
    PubMed
    Summary

    Two photoscreening devices showed lower sensitivity but higher specificity than manual screening for preschool children. These devices successfully screened children who could not be tested manually, indicating their utility.

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    Area of Science:

    • Ophthalmology
    • Pediatric Vision Screening

    Background:

    • Preschool vision screening is crucial for early detection of visual impairments.
    • Manual screening methods can be challenging for very young children.
    • Automated photoscreening devices offer a potential alternative for efficient vision assessment.

    Purpose of the Study:

    • To compare the referral accuracy of two widely used photoscreening devices against a standard manual screening protocol in preschool-aged children.
    • To evaluate the sensitivity and specificity of the Welch Allyn SPOT Vision Screener and the Plusoptix Vision Screener.
    • To assess the devices' performance in screening children who were unable to complete manual testing.

    Main Methods:

    • A cohort of 1,085 preschool children (aged 3-5 years) in Michigan participated in the study.

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  • Children underwent a standard vision screening using Lea Symbols and Stereo Butterfly tests.
  • Children who failed, couldn't be tested, or a subset who passed were then tested with SPOT and Plusoptix photoscreeners.
  • Sensitivity and specificity were calculated using the manual screening results as the gold standard.

    • Main Results:

    • The SPOT Vision Screener had a sensitivity of 61.0% and specificity of 92.9%.
    • The Plusoptix Vision Screener demonstrated a sensitivity of 65.2% and specificity of 82.4%.
    • Both devices successfully screened a majority of children (86.9% for SPOT, 73.8% for Plusoptix) who could not be tested manually.

    Conclusions:

    • Photoscreening devices identified fewer false positives but also missed some cases (false negatives) compared to manual screening.
    • The ability of these devices to screen children who are difficult to test manually highlights their practical value in preschool vision programs.
    • Further refinement may be needed to improve the sensitivity of photoscreening devices for comprehensive preschool vision assessment.