title: Comparison of the MTI Photoscreener and the Welch-Allyn SureSight autorefractor in a tertiary care center.
abstract: 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..
authors.affiliation: Indiana University School of Medicine, Department of Ophthalmology, Section of Pediatric Ophthalmology and Adult Strabismus, Indianapolis, Indiana, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Rogers
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Neely
authors.forename: Janice B
authors.initials: JB
authors.lastname: Chapman
authors.forename: David A
authors.initials: DA
authors.lastname: Plager
authors.forename: Derek T
authors.initials: DT
authors.lastname: Sprunger
authors.forename: Naval
authors.initials: N
authors.lastname: Sondhi
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Roberts
authors.forename: Susan
authors.initials: S
authors.lastname: Ofner
mesh_terms: 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*