June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Review of Hyperopia Screening Referral Criteria 4.00D
Author Affiliations & Notes
  • Joannah Vaughan
    Elks Children's Eye Clinic, Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Talitha Dale
    Elks Children's Eye Clinic, Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Daniel Herrera
    Elks Children's Eye Clinic, Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Daniel Karr
    Elks Children's Eye Clinic, Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Joannah Vaughan None; Talitha Dale None; Daniel Herrera None; Daniel Karr None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1461. doi:
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      Joannah Vaughan, Talitha Dale, Daniel Herrera, Daniel Karr; Review of Hyperopia Screening Referral Criteria 4.00D. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1461.

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

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Abstract

Purpose : The Elks Preschool Vision Screening Program’s (Program) goal is to identify ideal referral criteria when screening children for amblyopic risk factors. Currently the Program refers for hyperopia at 2.50D. In 2022, American Association for Pediatric Ophthalmology and Strabismus (AAPOS) changed the screening referral recommendation for hyperopia to 4.00D.

Methods : Approval was obtained from the Institutional Review Board (IRB) to collect and review data on vision screenings throughout 2018-2022. Chart notes were reviewed from dilated eye exams. Children without complete measurement data from their Plusoptix (PO) screening were removed from analysis. Plusoptix option 4 settings were used and out of range hyperopia was considered 5.00D per Plusoptix out of range cutoff.

Results : Based on 233 dilated eye exams performed by pediatric ophthalmologists (194) and pediatric optometrists (39), mean age 4-years old, treatment for hyperopia was prescribed to 26 out of 36 referred when using the PO 2.50D hyperopia setting. When using AAPOS 4.00D hyperopia referral criteria, only 7 of the 26 treated children would have been identified. Using a 4.00D referral cutoff would have missed 19 children needing treatment. Receiver Operating Characteristic Curve (ROC) analysis shows that the optimal screening referral cutoff for hyperopia is 2.00D.

Conclusions : When hyperopia settings were set at 2.50D, 72% referrals received treatment. When using 4.00D, these children would not have been identified or received treatment. More research on hyperopia settings should be conducted to optimize sensitivity and specificity for a public vision screening program.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

 

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