The effectiveness of the Spot Vision Screener in detecting amblyopia risk factors

Abstract

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.

Accuracy of the Spot and Plusoptix photoscreeners for detection of astigmatism

“…2–6 As in the present study, the Spot had a higher success rate in providing estimates of refractive error in two of three studies that directly compared the two instruments. 2,3,5 However, the success rate for the Plusoptix in the present study was much lower than observed in pediatric ophthalmology clinic samples, suggesting that the low success rate we observed was due to the high rate of astigmatism in our study population.…”

“…2–6 In addition, when using a composite examination-positive definition (eg, “astigmatism or hyperopia or myopia or anisometropia”), the same instrument version and same criteria may still yield different specificity and sensitivity for the composite outcome in populations with different relative prevalences of the different types of refractive error. Reports of sensitivity across studies has been good for both instruments (>80%), although specificity has varied most likely due to differences in study populations (age range, presence of ocular abnormalities, inclusion of children with developmental delay, etc).…”

“…Reports of sensitivity across studies has been good for both instruments (>80%), although specificity has varied most likely due to differences in study populations (age range, presence of ocular abnormalities, inclusion of children with developmental delay, etc). In a cohort of 444 1- to 16-year-olds screened with the Spot (as in the present study, using Spot software v2.0.16 and applying current AAPOS referral criteria for both screening and examination results 10 ), Peterseim and colleagues 6 found a sensitivity of 84.8, specificity of 70.9, PPV of 78.1, and NPV of 79.2, compared with 96%, 87%, 90%, and 94%, respectively, in the present study. The Spot’s poorer performance in their study may be due in part to the fact that it included younger children, many with significant ocular pathology.…”

Procedures for the Evaluation of the Visual System by Pediatricians

“…Photoscreening has been shown to have high sensitivity and specificity in community and office settings. [14][15][16][17][18][19][20] Photoscreening instruments assess both eyes simultaneously and the images can be interpreted by trained operators, by a central reading center, or with computer software.…”

Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital: Outcomes and ocular healthcare-seeking behaviours

“…24 Rapid vision screening methods have previously been proposed for adults. 25 However, such methods often involve computer-assisted tools and are not portable. In contrast, the Spot ™ Vision Screener (Welch Allyn Inc.) is a handheld unit that provides rapid measurements and has been validated in the detection of risk factors for amblyopia and uncorrected refractive errors in children.…”