Evaluation of the Spot Vision Screener in School-Aged Children

Abstract

Purpose: To determine the accuracy of the Spot Vision Screener (Welch Allyn, Skaneateles Falls, NY) in children 6 years and older and recommend device thresholds to improve its accuracy for the detection of refractive error. Methods: The Spot Vision Screener results were compared with three gold standard conditions of increasingly narrow refractive error criterion. The sensitivity, specificity, positive predictive value, and negative predictive value of the Spot Vision Screener in detecting each gold standard criterion were calculated. The most accurate threshold setting for each parameter was identified by calculating the area under the curve receiver operating characteristic. Results: The Spot Vision Screener was able to successfully evaluate 313 of 330 children (95%). The sensitivity of the Spot Vision Screener to detect American Association for Pediatric Ophthalmology and Strabismus guidelines for amblyopia risk factors was 89.5% and the specificity was 76.7%. The sensitivity decreased to 80% and the specificity increased to 75.3% with narrower refractive criteria. The sensitivity in detecting refractive criteria improved with the proposed optimized device thresholds. Estimates for the general population indicate that the positive predictive value is reasonable at 52.3% to 61.8%, depending on the stringency of the criteria, with excellent negative predictive values. Conclusions: In school-aged children, the primary screening focus shifts from preventing amblyopia to detecting visual disturbances, including refractive error, that may interfere with academic performance. In this age group, the Spot Vision Screener was an acceptable method of detecting significant refractive error with improved sensitivity with threshold optimization. [ J Pediatr Ophthalmol Strabismus . 2020;57(3):146–153.]

Prevalence of Myopia and Its Associated Factors Among Japanese Preschool Children

“…In the current study, preschool children were examined using a binocular vision system in a non-mydriatic state. The SVS is widely used for refractive examinations in young children and is gradually gaining recognition in both clinical practice and research because of its rapidity, maneuverability, accuracy, and reproducibility ( 26 – 28 ). To reduce the effect of strong accommodation, myopia was additionally assessed by both non-cycloplegic autorefraction and visual acuity in our study.…”

The Incidence and Severity of Myopia in the Population of Medical Students and Its Dependence on Various Demographic Factors and Vision Hygiene Habits

“…What is more, our study shows that performing a myopia screening is possible even during events such as the COVID-19 pandemic. Additionally, the high sensitivity and specificity of the used photoscreener were confirmed by former studies [ 20 , 21 , 22 , 23 ], making it a potential tool for the population’s general refractive error assessment. The study was not fully randomized.…”

“…Vision acuity was tested using a Snellen chart over the exact distance of 5 m [ 19 ]. Refractive error was measured using an SVS-100S photoscreener (Spot Vision Screener) by the Welch Allyn, described in the literature as an acceptable method of screening refractive errors [ 20 , 21 , 22 , 23 ]. Participants were sitting upright, each in the same type of chair, while the person who was performing the procedure was standing at the distance recommended automatically by the auto refractometer.…”

The Effect of Biometric Parameters on Spot Vision Screener Results

“…Instrument-based vision scanning has been recommended by the American Association for Pediatric Ophthalmology and Strabismus [AAPOS] and the American Association of Certi ed Orthoptists [AACO] [21]. Many studies have reported that SVS effectively detects refractive errors and prevents refractive amblyopia in preschool children [22][23][24][25].…”