Flip chart Visual Acuity Screening for Amblyopia Risk Factors Compared to the PlusoptiX A09 Photoscreener,Tests Performed by a Lay Screener.

IMPORTANCE

The gold standard of vision screening is considered acuity testing, this article will compare the gold standard against new technology to provide more choices for pediatric vision screening programs.

OBJECTIVE

To determine the reliability of recognition visual acuity screening performed by a lay screener compared to the plusoptiX A09 photoscreener for the detection of amblyopia risk factors.

DESIGN

One lay screener received basic training in how to test monocular visual acuity using the 10 foot Patti Pics single crowded chart and the plusoptiX A09 photoscreener. All children underwent a complete pediatric ophthalmology examination and cycloplegic refraction after screening and this examination was the standard against which the screening method was compared. Each patient received a pass or refer grade after either screening. For the Patti Pics screening, children were referred if they failed to reach threshold visual acuity of twenty forty in either eye; the plusoptiX determines if the child is a pass or refer based on pre-set referral criteria.

SETTING

Pediatric ophthalmology clinic.

PARTICIPANTS

Screening was performed on children ages 3 to 10 years.

RESULTS

Seventy-one children were screened. Flip chart-screening was found to have a sensitivity of 83%, specificity of 44%, false positive rate of 56% and false negative rate of 17%. Those same metrics for the plusoptiX A09 were 94%, 89%, 11% and 6%, respectively.

CONCLUSION

The plusoptiX photoscreener was more sensitive and specific in making appropriate referrals for further care than flip chart-screening in this cohort of children age 3-10. The plusoptiX A09 photoscreener operated by a lay screener is a reliable method to screen for amblyopia risk factors. These finding have important implications for community based vision screening, and screening in the medical home.