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M. T. Kulp, Vision in Preschoolers (VIP) Study Group; Detection of Significant Refractive Error With SureSight Vision Screener. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1012.
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The Vision In Preschoolers (VIP) Study Group has shown that screening tests of refraction perform best in identifying significant refractive error in preschool children. However, the ability of the tests to identify children with specific types of significant refractive error has not been investigated. The purpose of this study is to evaluate the ability of the SureSight Vision Screener to detect hyperopia, myopia, astigmatism, and anisometropia.
As part of the VIP Study, 1446 Head Start preschool children had refractive error measured by the SureSight Vision Screener in child mode, followed on a later day by cycloplegic retinoscopy by a pediatric eyecare professional masked to the SureSight results. Significant refractive errors on cycloplegic retinoscopy were defined as: hyperopia >+3.25D in any meridian; myopia > -2.00D in any meridian; astigmatism > 1.50D between principal meridians; and anisometropia > 1.00D interocular difference in hyperopia, or > 3.00D interocular difference in myopia, or > 1.50D interocular difference in astigmatism. The ability of the SureSight measurements to identify each refractive error was summarized by the area under the receiver operating characteristic (ROC) curve using all possible cutpoints for defining failure. Detection of refractive error type was based upon the child’s worse eye and using the following SureSight
most positive meridian for hyperopia, most negative meridian for myopia, cylinder for astigmatism and difference in spherical equivalent for anisometropia. Results: The mean spherical equivalent was 1.43 D (± 1.52D) and the range was from -17.00D to +9.50D. The criterion for significant refractive error was met by 168 children for hyperopia, 25 for myopia, 156 for astigmatism and 94 for anisometropia. Area under the ROC curve ranged from a high of 0.95 for myopia (95% CI: 0.93 to 0.98) and astigmatism (95% CI: 0.94 to 0.96) to 0.83 for hyperopia (95% CI: 0.80 to 0.86) to 0.69 for anisometropia (95% CI: 0.63 to 0.75).
Detection of significant refractive error with SureSight Vision Screener was very good for astigmatism and myopia, good for hyperopia, and fair for anisometropia.
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