The Receiver-Operator Curve for Flip-Card Surround HOTV in Younger School Children: Validation of a Simple Flip Card for School Acuity Testing

Abstract

Patched surround HOTV flip-card acuity is useful in starting school children and a cut-off of 20/25 passing acuity is suggested. Pre-kindergarten are not well acuity screened due to high inconclusive rate.

Accuracy and repeatability of refractive error measurements by photorefractometry

“…Visual acuity (VA) assessment among young children is difficult and unreliable,[ 5 6 ] therefore indirect investigation for amblyopia through measurement of refractive errors is advantageous. [ 7 ] Cycloplegic refraction is considered as the gold standard for detecting refractive errors,[ 3 ] although its application in screening programs entails problems such as being time consuming, requirement for supervision to monitor cycloplegia side effects, and increasing screening expenses and complications.…”

A Comparison of Patched HOTV Visual Acuity and Photoscreening

“…Of the students screened, 14% had confirmatory exams and another 65% had very normal patched acuities combined with normal photoscreens, providing estimates of screening validation. Elements of validation for these tests are reported elsewhere (Arnold, Stark et al, in press; Leman, Armitage, & Arnold, 2005). The overall sensitivity:specificity was estimated using AAPOS guidelines for the modalities to be about 39%:99% for patched HOTV acuity, 77%:99% for MTI photoscreening, and 85%:98% for Gateway photoscreening.…”

“…Near testing did not afford an enhancement over pinhole testing in this series. Figure 3 is a receiver-operator characteristic curve using the AAPOS-criteria (Donahue et al, 2003) “silver standard” (Leman et al, 2005) confirmatory exams on 1,340 of the 1,677 children screened. The curve indicates the positive predictive effect of adding pinhole to the screening for those students failing patched acuity and the increased sensitivity when pass-threshold acuity is moved to 20/25 from our AAPOS guidelines of 20/40 for prekindergarteners and 20/32 for older students (Leman et al).…”

Performance of the plusoptiX S04 photoscreener for the detection of amblyopia risk factors in children aged 3 to 5

“…2 The software allows for customized criteria on the basis of the patient's age, that is, 6 to 12 months, 12 to 36 months, 37 to 72 months, and 73 to 240 months. For each group there are referral criteria for 5 distinct measurements, including anisometropia, astigmatism, myopia, hyperopia, and anisocoria.…”

“…There is evidence that eye chart acuity screening may be ineffective for young children (\4 years of age). 2 Photoscreening may be a better option in this group of children, but with the unavailability of the MTI photoscreener, more options are needed. The plusoptiX S04 (Plusoptix GmbH; Nuremberg, Germany) is a photoscreening device that provides not only an image but also an autorefractive reading and instant results, which can be printed on a colorful certificate for the parents.…”