Field Evaluation of Automated Vision Screening Instruments: Impact of Referral Criteria Choice on Screening Outcome.

Purpose: Automated vision screeners can identify children with amblyopia risk factors. Two screening instruments having different referral criteria were evaluated in a community setting: SPOT (Pediavision, Lake Mary, FL) (sensitive manufacturer's referral criteria) and plusoptiX S08 (Plusoptix GmbH, Nuremberg, Germany) (specific modified Arthur referral criteria).
Methods: All children were screened by SPOT, and referred children were then screened using plusoptiX. Referred children received a gold standard examination to determine whether amblyopia risk factors were present.
Results: A total of 2,801 treatment-naïve children were screened using SPOT. Of these, 307 (11.0%) were referred by SPOT and subsequently screened by plusoptiX; 100 received a gold standard examination. Amblyopia risk factors were present in 43% (43 of 100) referred by SPOT compared to 72.7% (32 of 44) for plusoptiX. Eleven of 56 referred by SPOT had amblyopia risk factors that would have been missed by plusoptiX, including three with mild amblyopia.
Conclusions: PlusoptiX with modified Arthur referral criteria can be a highly specific screening device detecting amblyopia risk factors without missing children with moderate/severe amblyopia.
(Copyright 2015, SLACK Incorporated.)