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C. A. Johnson, B. D. Moore, S. Lyons, K. Majzoub, J. Ramsey, A. Swan-Mahony, L. Deng; The Massachusetts Kindergarten Vision Screening Study: Investigating the Suresight (SS) Autorefractor Alternative. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1591.
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To compare the sensitivity and specificity of combinations of 3 vision screening tools for detecting vision disorders in kindergarten children.
457 Boston Public Schools (BPS) kindergarten students were screened by paraprofessionals using the mandated Massachusetts (MA) protocol (MassVAT Lea Symbols and Random Dot E) and a SureSight (SS) autorefractor. Paraprofessionals received introductory training in all protocols and performed screenings in typical environments within BPS. All children who did not meet either MA protocol or SS pass criteria along with a matched number who had passed both were referred for a comprehensive eye exam by pediatric optometrists. The exam was the gold standard for identifying targeted conditions as defined previously by the Vision In Preschoolers Study Group for refractive error, amblyopia, and strabismus. The primary outcome measures were the sensitivity and specificity of each tool or tool combination for detecting targeted vision disorders.
131 children failed their vision screening, while 154 were consented and received the exam (76 who passed and 78 who failed). Sensitivities and specificities for detecting targeted conditions are listed in the Table.
Relative to the mandated MA protocol, vision screening using SS autorefraction in combination with MassVAT Lea visual acuity yields a considerable improvement in the detection of targeted vision disorders in kindergarten children. This is true even when performed in "real world" screening environments by minimally trained screeners who would typically be responsible for completing BPS screenings. This combined protocol should be considered as an alternative for kindergarten vision screening.
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