Inter-Screener Agreement in Refractive Error Measurements between Nurse and Lay Screener in Administering Retinomax and SureSight

Abstract

 

Purpose:

 

To determine the inter-screener agreement of refractive error measurements between nurse and lay screeners in administering the Retinomax Autorefractor (Retinomax) and the SureSight Vision Screener (SureSight).

 

Methods:

 

1452 Head Start preschoolers (aged 3- to 5-years old) were enrolled into the Vision In Preschoolers (VIP) Phase II Study. Both trained pediatric nurse screeners and trained lay screeners conducted screening in a random order using the Retinomax and SureSight for each eye of the children. The inter-screener agreements between nurse and lay screeners were assessed for sphere, cylinder and spherical equivalent (SE), using mean inter-screener difference and the 95% limits of agreement.

 

Results:

 

As shown in Table, the Retinomax demonstrated good inter-screener agreement between nurse and lay screeners. The mean inter-screener differences were within 0.04 D. The 95% limits of agreement were within 2.2 D for both sphere and SE and 0.9 D for cylinder. The SureSight had a mean inter-screener difference within 0.25 D and 95% limits of agreement within 2.3 D for sphere and cylinder. While the Retinomax had better inter-screener agreement in cylinder than the SureSight, both instruments had similar inter-screener agreement of SE. The inter-screener agreement did not differ by preschooler age for either instrument.

 

Conclusions:

 

Among the Head Start preschoolers, the results of screening by trained nurses and lay screeners agree well in measuring refractive error using the Retinomax or SureSight. Both instruments had similar inter-screener agreement in SE.  

 

Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques • refractive error development