title: Photoscreeners in the pediatric eye office: compared testability and refractions on high-risk children.
abstract: OBJECTIVE
  To compare refractive data and testability of Spot (PediaVision) and Plusoptix A09 (Plusoptix, Inc) photoscreeners and to compare each device with traditional cycloplegic retinoscopy.
  
  
  METHODS
  Prospective, interventional case series.
  
  
  METHODS
  After informed consent, patients underwent testing with the Spot and Plusoptix photoscreeners before their examination by a pediatric ophthalmologist masked to the results. Data including testability and estimated refractions were entered into a Research Electronic Data Capture database for statistical analysis.
  
  
  RESULTS
  A total of 265 children were enrolled (mean age, 6.0 ± 3.4 years). Both devices produced a computer printout result in 250 (94.3%) of the patients. The Spot photoscreener provided a refractive estimate in all computer printouts, whereas the Plusoptix, used binocularly, provided a refractive estimate in 75.2% (188/250) of the printouts. Compared with cycloplegic retinoscopy, both devices underestimated hyperopia or overestimated myopia (-1.35 diopters [D] and -0.64 D, Spot and Plusoptix, respectively) and overestimated astigmatism (0.36 D and 0.32 D, Spot and Plusoptix, respectively). The intraclass correlation coefficient for spherical equivalents indicated good agreement between cycloplegic retinoscopy and Spot (0.806) and excellent agreement between cycloplegic retinoscopy and Plusoptix (0.898).
  
  
  CONCLUSIONS
  The Spot photoscreener provided refractive data on a greater percentage of children. The photorefractors correlated with cycloplegic retinoscopy refractive findings for sphere and spherical equivalents, but underestimated hyperopia or overestimated myopia and overestimated astigmatism. The binocular refractions of Plusoptix agreed more closely with the refractions of our pediatric ophthalmologists.
authors.affiliation: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: petersem@musc.edu.
authors.forename: Mae Millicent W
authors.initials: MM
authors.lastname: Peterseim
authors.affiliation: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Papa
authors.affiliation: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: M Edward
authors.initials: ME
authors.lastname: Wilson
authors.affiliation: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Cheeseman
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Wolf
authors.affiliation: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Davidson
authors.affiliation: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Rupal H
authors.initials: RH
authors.lastname: Trivedi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis* / Q000503:physiopathology; D015203:Reproducibility of Results; D042262:Retinoscopy / Q000379:methods; D015351:Vision Screening / Q000295:instrumentation*
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