Abstract
Abstract: :
Purpose: To compare the sensitivity of 11 preschool vision screening tests administered by licensed eye care professionals for the detection of the 4 VIP–targeted vision disorders when specificity is 94%. Methods: Three– to 5–year–old preschool children (N = 2588), 57% of whom had failed an initial Head Start vision screening, participated in this multicenter, cross–sectional study. Screening results from 11 tests were compared to results from a standardized eye exam that was used to classify children with respect to the 4 VIP–targeted vision disorders: amblyopia, strabismus, significant refractive error, and unexplained reduced visual acuity (VA). With overall specificity set to 94%, sensitivity for the detection of each targeted vision disorder was calculated. Results: At 94% specificity, the most accurate tests for detection of amblyopia were noncyloplegic retinoscopy (NCR) (88% sensitivity), SureSight Vision Screener (80%), and Retinomax Autorefractor (78%). The most accurate tests for detection of strabismus were MTI Photoscreener (65%), cover–uncover test (60%), Stereo Smile II stereoacuity (58%), SureSight Vision Screener (54%), and the Retinomax Autorefractor (54% in year 1, 53% in year 2). For detection of significant refractive error, the most accurate tests were NCR (74%), Retinomax Autorefractor (66%), SureSight Vision Screener (63%), and Lea Symbols Distance VA (58%). For detection of reduced VA, the most accurate tests were the Lea Symbols Distance VA test (48%), the Retinomax Autorefractor (39%), and NCR (38%). Conclusions: Similar to previously reported results at 90% specificity, the screening tests vary widely in sensitivity with specificity set at 94%. The rankings of the sensitivities for detection of the 4 VIP–targeted vision disorders are similar to those with specificity set to 90%.
Keywords: screening for ambylopia and strabismus • visual acuity • amblyopia