A Comparison of Patched HOTV Visual Acuity and Photoscreening

Abstract

Early detection of significant vision problems in children is a high priority for pediatricians and school nurses. Routine vision screening is a necessary part of that detection and has traditionally involved acuity charts. However, photoscreening in which "red eye" is elicited to show whether each eye is focusing may outperform routine acuity testing in pediatric offices and schools. This study compares portable acuity testing with photoscreening of preschoolers, kindergarteners, and 1st-graders in 21 elementary schools. School nurses performed enhanced patched acuity testing and two types of photoscreening in a portable tent. Nearly 1,700 children were screened during spring semester 2004, and 14% had confirmatory exams by community eye care professionals. The results indicate that one form of photoscreening using a Gateway DV-S20 digital camera is significantly more sensitive to children with significant vision problems, as well as being the most cost effective (85% specificity and only $0.11 per child). This suggests that the adaptation of photoscreening into a routine vision screening protocol would be beneficial for efficiently detecting vision problems that could lead to amblyopia.

Calibration and Validation of Nine Objective Vision Screeners With Contact Lens-Induced Anisometropia

“…The Alaska Blind Child Discovery recommends that valid objective screening be offered as a part of AAPOS guideline vision screening during the following age ranges: 12 to 24 months, 36 to 59 months, and at kindergarten entry; photoscreening can outperform patched acuity screening by school nurses in kindergarten and pre-kindergarten students. 11 This current study suggests that all nine objective screeners were capable of sorting cases with refractive error in normal range from those with amblyopiagenic, induced hyperopic anisometropia. An experienced central reading center is recommended for interpretation of photo screen images.…”

“…Guidelines for validation of preschool photoscreeners were developed and published in 2003 by the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). 6 The setting for validation of pediatric vision screening includes large, deliberate federally funded cohort studies, 4,7,8 in-pediatric-eye-offi ce high prevalence comparison, 9 pediatrician offi ce screening comparison, 10 school nurse comparison screening, 11 and statewide community screening. 12,13 Each of these settings has advantages and disadvantages, including cost, scope, and duration of time.…”

Scope and costs of autorefraction and photoscreening for childhood amblyopia—a systematic narrative review in relation to the EUSCREEN project data

“…Only 13 (24%) studies directly compared different test options [29,49,[55][56][57][58][59][60][61][62][63][64][65][66]. Four (7%) reported schemes where VA was the primary test, with photoscreening as an adjunct or part of a test battery [65][66][67][68].…”

“…Only three of the 23 papers were from outside the US (Germany [56], Belgium [83] and Japan [67]) and six papers presented data from non-typical settings e.g. Alaska, with a remote, sparse population [24,26,31,32,62] or from a minority ethnic population at higher risk of astigmatism [63].…”

Towards Worldwide Amblyopia Elimination – Vision Screening

“…5 In a practical sense, mass acuity screening of children is much more feasible after nursery age, and is not feasible children with language or developmental disabilities. 66,67 Therefore, it is not a question of whether objective tests or acuity tests are better: they should be used in age-related sequence during the years of amblyopia susceptibility.…”