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Noura A. Aldossary, Ali M AlSaqr, Elise B Ciner, Noura Aldohayan; Preschool Vision Screening by Parents Using an iPad in Saudi Arabia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3101. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Use of iPads is widespread in Saudi Arabia and present in most households. Early vision screening before 6 years of age is not common. The aim of this pilot study is to evaluate the ability of parents to administer an iPad-based preschool vision screening and to compare criteria for referral.
Children ages 3 to <6 years presenting for an eye examination with a parent at Prince Sultan Military Medical City, Riyadh were invited to participate. Parents were required to have prior experience using an iPad to participate. Children underwent screening (SC) with an iPad based visual acuity (VA) test (iSight, Kay Pictures Limited, UK) followed by an eye exam with cycloplegia (EE). The SC began with parent administration of the iSight on their child. An optometrist (O) who was masked to the parental results then performed the iSight on the child. The EE by a pediatric ophthalmologist included: monocular VA, distance and near cover test, cycloplegic refraction and ophthalmoscopy. Outcomes were testability (T) along with, sensitivity (SN) and specificity (SP) (95% Confidence Interval [CI]) with criteria by iSight (<20/25) or the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) age based screening criteria.
40 children (21 female,18 male, average age 52.35 months SD±10.4) and 38 parents (22 female,16 male) participated (2 parents came with 2 children each). Most parents were Saudis (97.4%) and living in Riyadh (89.5%). 26(65%) of children failed the EE; 6(23.1%) had >3.5 diopters (D) hyperopia, 8(30.8%) had bilateral astigmatism >1.5D, 1(3.8%) had ≥1D anisometropia, 8(30.8%) were amblyopia suspects and 3(11.5%) were strabismic. The T of iSight was 90% for parents and O. With iSight criteria, the SPs by the parents and O were 76.92% [46.19, 94.96] and 84.62% [ 54.55,98.08], while SNs were both 100% [85.18, 100.00]. With AAPOS criteria, SNs by parents and O were reduced to 60.87% [38.54, 80.29] and 56.52% [34.49, 76.81], while the SPs were improved to 100% [75.29,100].
Parents performed similarly to an O on the iSight. Although the iSight provides parents in Saudi Arabia the ability to screen their children for vision disorders at home, findings from this pilot show low sensitivities or specifities. These results are consistent with previous studies of VA screening tests. Further investigation may help to determine iSight applicability for screening in Saudi Arabia.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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