June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Screening for high hyperopia in infants at a pediatric medical practice in Columbus, Ohio
Author Affiliations & Notes
  • Ann Morrison
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Donald O Mutti
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Footnotes
    Commercial Relationships   Ann Morrison, Welch Allyn, Inc. (C); Donald Mutti, Welch Allyn, Inc. (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4599. doi:
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      Ann Morrison, Donald O Mutti; Screening for high hyperopia in infants at a pediatric medical practice in Columbus, Ohio. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4599.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the proportion of infants in a pediatric medical practice who have high levels of hyperopia (≥ +5.00 D in the most hyperopic meridian in at least one eye) in addition to evaluating the ability of the Welch Allyn SureSight to detect highly hyperopic refractive errors compared to the gold standard of cycloplegic retinoscopy.

Methods : Subjects were 98 infants (60 female) who presented for their 2-month well-baby visit with their pediatrician, and whose parents agreed to a vision screening from June 20th, 2019 to November 14th, 2019. The mean age of subjects was 62.6 ± 5.9 days. Cycloplegic refractive error (1% tropicamide) was measured with both the Welch Allyn SureSight and retinoscopy.

Results : Retinoscopy was successfully completed in 97 out of 98 infants but in only 90 out of 98 infants with the SureSight. The mean spherical equivalent refractive error by cycloplegic retinoscopy of subjects’ right and left eyes together was +2.58 ± 1.45 D. The mean spherical equivalent refractive error by Welch Allyn SureSight was +2.25 ± 1.46 D. The retinoscopy measurements were 0.14 ± 0.73 D more hyperopic than the SureSight measurements (paired t-test; p<0.039) with 95% limits of agreement of ± 1.43 D. Of the 97 infants screened with retinoscopy, 11 (11.2%) had a refractive error in the most hyperopic meridian of +5.00 D or greater in at least one eye. SureSight detected these infants with a sensitivity of 36.4% (4/11) and specificity of 100% (87/87).

Conclusions : Screening for high hyperopia in a pediatric medical practice is feasible with a high rate of testability and successful integration of dilation and refractive error assessment into the flow of the medical exam. As currently used, the SureSight does not seem to have adequate sensitivity for this purpose. The large proportion of highly hyperopic infants found by retinoscopy suggests that there are a substantial number of infants at greater risk for developing visual problems such as strabismus and amblyopia that are currently going undetected. Enhanced methods for vision screenings should be developed for use in a pediatric medical setting.

This is a 2020 ARVO Annual Meeting abstract.

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