[Mobile device-based childhood vision screening for early detection of amblyopia]

Introduction: Amblyopia, or lazy eye, is a developmental disorder of binocular origin, most commonly defined as vision impairment affecting one eye that cannot be corrected with lenses. With its high prevalence globally, it poses a public health concern, hence the important goal of early childhood vision screenings is the prevention and early treatment of amblyopia. Objective: Our aim was to develop and evaluate a mobile application-based stereovision test (EuvisionTab® stereotest, ETS) to timely detect amblyopia and its risk factors (strabismus, refractive errors). Method: In our study, we compared internationally recognized clinical stereotests (Lang II, TNO, Stereo Fly, Frisby) with the EuvisionTab stereotests in children (n = 453, mean age: 7.45 years). For the EuvisionTab stereotest consisting of random dots, four different settings were used, with altering dynamics, dot density, and visual noise. The effectiveness of the tests was evaluated using receiver-operating characteristic (ROC) analysis with area under the curve (AUC) being the most important measure. Results: The EuvisionTab stereotests showed high sensitivity compared to classical clinical tests, but their specificity lagged behind in some cases. For amblyopia, the dynamic test with low density and visual noise achieved the best sensitivity (91%), while the static test with high density achieved the best specificity (89%). Among the traditional clinical tests, TNO had the best sensitivity (88%), while the Lang test had the best specificity (98%). According to ROC analysis, all applied stereotests are good or excellently suitable (ROC-AUC>0.80) for amblyopia screening, while for strabismus, TNO, Stereo Fly, and EuvisionTab stereotests met this criterion. Conclusion: EuvisionTab stereotests have proven to be suitable for amblyopia screening, exhibiting high sensitivity. Additional benefits of the method include random stimulus sequences, flexible parameter settings, statistical decision-making, convenient documentation, and easy and fast implementation. With these advantages, it has the potential to become an integral component of state-of-the-art vision screening protocols. Orv Hetil. 2024; 165(16): 620–628.