Reliability of Smart Phone Photographs for School Eye Screening

Abstract

Smartphone photographs capturing Bruckner’s reflex have demonstrated reliability in identifying amblyogenic conditions in children. Assessing visual acuity for screening has been the traditional method since the inception of school screening. The present study aims to assess the reliability of smartphone photographs in detecting ocular morbidities in school children and to compare it with traditional vision screening. Two thousand five hundred and twenty school children underwent vision screening and smartphone cameraphotography by a trained research assistant followed by a comprehensive eye examination of all children by an ophthalmologist. Children with unaided visual acuity less than 6/12 in either of the eyes were graded as abnormal. Based upon the characteristics of the Bruckner’s reflex, the photographs were graded as normal or abnormal by two investigators blinded to the clinical findings. Statistical analysis was performed to compare the sensitivity and specificity of traditional vision screening and photograph based screening, considering comprehensive eye examination as the gold standard. The sensitivity and specificity of vision screening was 81.88% and 97.35% whereas for photographs it was 94.69% and 98.85% respectively. When the two methods were compared, the p value was <0.05. We conclude that smartphone photography is better than traditional vision screening for detecting ocular morbidities in school children.

Automatic Refractive Error Estimation Using Deep Learning-Based Analysis of Red Reflex Images

“…The test was determined to have a sensitivity of 91% and specificity of 72.8%, with overall data supporting the use of the Brückner test in screening for refractive errors. A recent study based on smartphone photography reported by Srivastava et al [24] has used Brückner's reflex and has demonstrated reliability in identifying amblyogenic conditions in school children.…”

Special Issue “Pediatric Eye Disease: Screening, Causes and Treatment”

“…Modern technologies are being increasingly applied. Smart phones can be used to provide convenient and effective eye screening for children [ 8 , 9 ].…”