Comparison of the MTI Photoscreener and the Welch-Allyn SureSight autorefractor in a tertiary care center.
BACKGROUND
The MTI photoscreener (MTI) and the Welch-Allyn SureSight autorefractor are commonly used for preschool vision screening. We compared both of these methods on 100 consecutive patients in a prospective, randomized, masked, clinical trial conducted at a tertiary care center.


METHODS
One hundred patients between 1 and 6 years of age were included in the study. All participants underwent a comprehensive eye examination with cycloplegic refraction. Examination failure analysis was done on the SureSight data using the manufacturer's referral criteria, the Vision in Preschoolers study (VIP) 90% specificity criteria, the VIP 94% specificity criteria, and the referral criteria proposed by Rowatt and colleagues.


RESULTS
Data were successfully obtained on 76% of children using the SureSight and 96% with the MTI. The sensitivity and specificity of the SureSight to detect clinically significant amblyogenic factors using the manufacturer's criteria was 96.6 and 38.1%, using the VIP 90% criteria was 79.3 and 64.3%, using the VIP 94% criteria was 67.2 and 69.0%, and using criteria proposed by Rowatt and colleagues was 62.1 and 73.8%. The sensitivity and specificity of the MTI photoscreener was 94.8 and 88.1%, respectively.


CONCLUSIONS
Using the manufacturer's referral criteria, the SureSight had a sensitivity equal to the MTI photoscreener; however, the specificity was low and over-referrals were anticipated. As specificity levels were increased, a substantial number of children with amblyogenic risk factors were not appropriately identified within our study population..
Rogers
David L
DL
Indiana University School of Medicine, Department of Ophthalmology, Section of Pediatric Ophthalmology and Adult Strabismus, Indianapolis, Indiana, USA.
Neely
Daniel E
DE
Chapman
Janice B
JB
Plager
David A
DA
Sprunger
Derek T
DT
Sondhi
Naval
N
Roberts
Gavin J
GJ
Ofner
Susan
S
D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015351:Vision Screening / Q000295:instrumentation*