June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Instrument-Based Vision Screening: Integration into Primary Care with Referral and Follow-Up at Vision Center
Author Affiliations & Notes
  • E Eugenie Hartmann
    Vision Center and Research Institute, Akron Children's Hospital, Akron, Ohio, United States
  • Ian Boydstun
    Vision Center, Akron Children's Hospital, Akron, Ohio, United States
  • Richard W Hertle
    Vision Center, Akron Children's Hospital, Akron, Ohio, United States
  • Footnotes
    Commercial Relationships   E Eugenie Hartmann None; Ian Boydstun None; Richard Hertle None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1249 – A0357. doi:
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      E Eugenie Hartmann, Ian Boydstun, Richard W Hertle; Instrument-Based Vision Screening: Integration into Primary Care with Referral and Follow-Up at Vision Center. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1249 – A0357.

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

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Purpose : To investigate the relationship between screening outcomes using the SPOT Vision Screener at 3-, 4- and 5-year-old Well Child Checks (WCC) in general pediatric offices and comprehensive eye examination follow-up in the Vision Center specialty care clinics at Akron Children’s Hospital.

Methods : Staff and providers in pediatric offices were systematically trained on the use of the SPOT Vision Screener. This instruction included the importance of identifying amblyogenic risk factors in the preschool age group as well as hands on demonstration and practice with the device. Two primary care clinics were selected as initial sites for launching this project. Electronic charting was designed to automatically order and report instrument-based vision screening for all 3-,4- and 5-year-old WCCs. Results from SPOT screening were compared with findings from comprehensive eye examinations during the first four months of this new protocol.

Results : Of the 177 referrals resulting from 724 WCCs that included instrument-based vision screening, 87 patients (49% of referrals) presented for comprehensive eye examinations in the Vision Center. The SPOT results for one of these patients did not detect any abnormality, however, the provider had observed exotropia OD, which resulted in an accurate referral. Of the remaining 86 referrals based on the SPOT, 82 (95%) were identified as having astigmatism (unilateral, bilateral or with other potential conditions). A summary of the SPOT results by condition compared with the number of patients who were prescribed refractive error correction is shown in Table 1. Only 4 patients were identified by the SPOT as having a potential condition other than astigmatism. Patients identified with potential bilateral astigmatism only were twice as likely to be prescribed glasses based on the findings from their eye examination as patients identified with potential unilateral astigmatism only.

Conclusions : Understanding the effectiveness of instrument-based vision screening in pediatric offices requires tracking referrals, as well as outcomes of eye examinations. The preponderance of referrals we observed for astigmatism was not surprising based on the inherent design of these devices. Correlation of refractive errors obtained by our eye-care providers along with their treatment protocols will provide greater understanding of the strength and weaknesses of these devices.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.



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