Abstract
Purpose :
Debate surrounds the topic of most effective and efficient method of vision screenings for school-age children. This study used a prospective comparison to measure the sensitivity, specificity, and efficiency of two screening methods used for inner-city school children and how that relates to refractive error.
Methods :
191 children in odd grades ranging from kindergarten to seventh grade from Youngstown Community School had their vision screened with two different methods of screening procedure. From this we were able to determine the statistical difference between a spot-screener auto-refractor and a full screening battery, implemented by Ohio Department of Health. This includes including monocular distance VA, color vision, stereopsis, and near VA. Following the completion of both screening methods for all students, the students who failed either of the screener received a no cost, non-dilated eye exam to determine true refractive error, and glasses were provided. Failure rate of each screening method was determined. False positive and negative rates were also established
Results :
191 students that were screened, and 118 students failed one or both screeners. The failure rate for the Ohio Department of Health battery was 25%, while the failure rate for the spot-screener was 45%. Out of the 118 students who were screened and failed, 35 students failed both screening methods at 29%. The spot-screener screening method was more sensitive to detecting both hyperopia as well as astigmatism that was missed by the Ohio Department of Health vision screening battery. The data suggest that myopia was detect at the same rate by both screening methods. If efficiency is considered the time it takes to screen all 191 students at this school was approximately two school days, while the screening battery takes more than three weeks to contact every child. Based on results, the data suggest that the spot-screener auto-refractor screening method is more sensitive with fewer false negatives.
Conclusions :
Vision is one of the most influential factors to a child’s learning. Simple vision screenings are key to detecting vision deficits that can be corrected. Having the most efficient vision screener is critical, while also maintaining effectiveness. Based on our comparison of the two methods, the spot-screen auto-refractor is the most effective and efficient vision screening method, because of its low false negative rate and fast completion time.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.