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Cost-Effectiveness of photoscreeners in screening at-risk amblyopia in Indian children
Kaushik Murali1, C Vidhya2, Sowmya Raveendra Murthy2
1Director, Medical Administration, Sankara Eye Hospitals, Bengaluru, India.
Insights
Photoscreening devices like Plusoptix and 2WIN Adaptica are cost-effective for identifying children at risk of amblyopia. These tools are faster and cheaper than traditional methods, improving early vision screening.
Area of Science:
- Ophthalmology
- Public Health
- Pediatric Vision Screening
Background:
- Amblyopia, or
Purpose of the Study:
- To evaluate the cost-effectiveness of photoscreeners (2WIN Adaptica, Plusoptix) compared to autorefractor and Mohindra retinoscopy for identifying children at risk of amblyopia.
Main Methods:
- Prospective, open-label, randomized controlled study involving 2910 children aged 5-11 years.
- Photoscreening conducted by lay screeners, with data collated by a supervising ophthalmologist.
- Comparison of cost-effectiveness and screening time for different instruments.
Main Results:
- Plusoptix (4s) and 2WIN Adaptica (6s) demonstrated significantly faster screening times compared to other methods.
- Both Plusoptix and 2WIN Adaptica were found to be more cost-effective than Mohindra retinoscopy (P < 0.05).
Conclusions:
- Photoscreening with Plusoptix and 2WIN Adaptica by lay screeners is a highly cost-effective and efficient method for community-level screening of young children at risk of amblyopia.
- This approach is significantly faster and less costly than using autorefractors or Mohindra retinoscopy by trained optometrists.
Objectives:
Amblyopia is the most common cause of preventable vision impairment in children. This study tried to evaluate the cost-effectiveness of photoscreeners in identifying refractive errors making children at risk of amblyopia.
Materials And Methods:
This was designed as a prospective, open-label, randomized controlled study to compare the cost-effectiveness of photoscreeners (2WIN Adaptica and Plusoptix) versus autorefractor and Mohindra retinoscopy to identify the at-risk amblyopia. This study was conducted from October 2018 to December 2018 in coordination with Nanna Kannu school screening project and children in the age group of 5-11 years were included in the study. The photoscreening was done by lay screeners. A supervising ophthalmologist collated all data. Cost-effectiveness was calculated for the individual instruments and compared. The average time is taken for each instrument to record the refractive error was calculated and compared with the Mohindra retinoscopy.
Results:
Number of children included in this study was 2910. The mean age of the children was 7.82 + 0.65 years. The mean time taken for 2WIN Adaptica was 6 sec, Topcon -10 s, and Plusoptix -4 s. Plusoptix showed the minimal time for screening a child when compared to all other methods. The Plusoptix and 2WIN Adaptica were shown to be cost-effective when compared to Mohindra retinoscopy (P < 0.05).
Conclusion:
Photoscreening using Plusoptix and 2WIN Adaptica with lay screeners was < seven times the cost incurred and five times faster than the trained optometrists using either autorefractor or Mohindra retinoscopy and thus more cost-effective in screening a large number of young children with at-risk amblyopia at the community level.
