PURPOSE To compare refractive data and testability of Spot (PediaVision) and Plusoptix A09 (Plusoptix, Inc) photoscreeners and to compare each device with traditional cycloplegic retinoscopy. DESIGN 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.

Background The purpose of this study was to evaluate the updated Spot Vision Screener (PediaVision, Welch Allyn, Skaneateles Falls, NY) in detecting amblyopia risk factors using the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods In this prospective study, patients seen from June 2012 to November 2013 were tested with the Spot prior to examination by a pediatric ophthalmologist who was masked to test results. The following data were analyzed: age, subject testability, examination findings, and systemic and ocular pathology. Children were divided into three age groups to determine gold standard results according to the AAPOS guidelines. Results A total of 444 children (average age, 72 months) were included. Compared to the ophthalmologist's examination, the Spot sensitivity was 87.7% and the specificity was 75.9% in detecting amblyopia risk factors. There were no significant differences in sensitivity between the age groups, although the positive predictive value improved in the older age groups. Conclusions In our study cohort, the Spot provided good specificity and sensitivity in detecting amblyopia risk factors according 2013 AAPOS criteria, with minor improvements with updated versions.

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PURPOSE To evaluate the use of the Spot Vision Screener (Spot; Welch Allyn, Skaneateles Falls, New York, USA) for detection of amblyopia risk factors in children aged 6 months to 3 years, as defined by the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus. DESIGN Reliability analysis. METHODS In this study, children seen from June 1, 2012, to April 30, 2016 were tested with the Spot during a routine visit. Enrolled children underwent a comprehensive eye examination including cycloplegic refraction and sensorimotor testing within 6 months of the testing date by a pediatric ophthalmologist masked to the Spot results. RESULTS A total of 184 children were included. The Spot successfully obtained readings in 89.7% of patients. Compared with the ophthalmologist’s examination, the Spot had an overall sensitivity of 89.8% and a specificity of 70.4%. CONCLUSION The Spot achieved good sensitivity and specificity for detection of amblyopia risk factors in this young cohort, particularly in the older subgroup. Our data offer support for automated vision screening in young children.