Abstract
Purpose: :
To evaluate the positive predictive value of the Plusoptix S08 vision screener for detecting amblyogenic risk factors among a sample of the general kindergarten population.
Methods: :
All children enrolling in kindergarten during 2010 in a rural/suburban county received automated photoscreening with the Plusoptix S08 as a part of their enrollment. Students were excluded from screening if they were absent on the day of screening, if their parents did not give consent for screening, or if they wore glasses. Early in the study, a number of students (17) were excluded because they were unable to be screened with the Plusoptix device; during later screenings, students not able to be screened (7) were referred for gold standard examination. Criteria for referral were a modification of those published by Arthur. Children were referred for a gold-standard comprehensive eye examination including cycloplegic retinoscopy by a local ophthalmologist or optometrist. Data collected included referral rate, referral reason, and positive predictive value.
Results: :
1999 of 2724 students (73%) from 29 public elementary schools were screened. 72 of screened students were referred (3.8%) for the following suspected conditions: high myopia (6), anisometropia (30), high hyperopia (24), astigmatism (32), unable to be screened (7). Many students were referred with multiple risk factors. 37 students have followed up for a comprehensive exam (51%) thus far in an ongoing effort. Of these 36 students, 32 received adequate exams. 26 of these 32 students failed gold standard exam for the following primary reasons: high myopia (3), anisometropia (17), astigmatism (5), strabismus (2). Our data indicates the screener has a positive predictive value of 81% for amblyogenic risk factors in the general kindergarten population.
Conclusions: :
The Plusoptix S08 can be used with a high success rate in kindergarteners and accurately identifies children with decreased visual acuity and refractive error.
Keywords: screening for ambylopia and strabismus • amblyopia