Vision screening in children by Plusoptix Vision Screener compared with gold-standard orthoptic assessment.
OBJECTIVE
To evaluate a new autorefractor, the Plusoptix Vision Screener (PVS), as a screening tool to detect risk factors for amblyopia by comparing it with gold-standard orthoptic vision screening in children.


METHODS
Community-based screening study including 288 children age 4-7 years who were screened with the PVS and by orthoptic assessment (distance acuity, cover test, extraocular movements, 20 PD prism test, Lang stereotest). Follow-up comprehensive eye examination of screening-positive children included manual cycloplegic retinoscopy.


RESULTS
Testability was high for both methods. Orthoptic screening identified 36 children with reduced vision and/or factors associated with amblyopia (referral rate 12.5%). The PVS identified 16 children with potential vision problems (referral rate 5.6%), indicating only moderate sensitivity (44%; 95% CI 27.9 to 61.9%), but high specificity (100%; 95% CI 98.5 to 100%) to detect factors associated with amblyopia. The PVS underestimated visually significant refractive errors.


CONCLUSIONS
Use of the PVS as single screening test in young children may miss a significant number of children with amblyopia or amblyogenic risk factors.
Dahlmann-Noor
A H
AH
Eye Treatment Centre, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St Edmunds IP33 2QZ, UK.
Vrotsou
K
K
Kostakis
V
V
Brown
J
J
Heath
J
J
Iron
A
A
McGill
S
S
Vivian
A J
AJ
D000550:Amblyopia / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis; D042261:Retinoscopes; D042262:Retinoscopy / Q000379:methods; D012680:Sensitivity and Specificity; D014741:Video Recording; D014787:Vision Tests; D014792:Visual Acuity