Journal of AAPOS
Published online April 24, 2019
Barugel et al. compared the specificity and sensitivity of the Spot Vision Screener, a handheld automatic photoscreener, with gold standard cycloplegic measurements in a population of underprivileged children and teenagers with limited access to medical care. They found that although the handheld screener detected most refractive errors, it fell short in accurately identifying cases of hyperopia.
For this study, 41 children 4 years and older with poor access to medical care were recruited by social workers and referred to a single hospital in Paris for refractive error screening during a full-day dedicated session. The children had a mean age of 126 months (range, 48-246 months).
The same orthoptist performed noncycloplegic refraction measurements using the Spot Vision Screener in all patients. In the absence of contraindications, cycloplegic autorefraction using the Retinomax K-Plus 3 autorefractometer (Righton) was performed and independently evaluated by an ophthalmologist. Slit-lamp and fundus examinations were performed in all cases. Glasses were prescribed as necessary.
The sensitivity of the Spot Vision Screener to detect myopia was high (>80%), at 84.61%. However, its sensitivity for the detection of hyperopia, astigmatism, and anisometropia was lower (<80%), at 27.27%, 78.57%, and 66.67%, respectively. The specificity for hyperopia, myopia, astigmatism, and anisometropia was high, at 100%, 98.55%, 89.71%, and 94.29%, respectively. The referral rate was 39.02%.
The Spot Vision Screener’s low sensitivity with regard to hyperopia seems to remain a limitation of the device, the researchers said, and they recommended cycloplegic refraction be considered in public health initiatives. Even with this limitation, they noted that the study offered a real-world example of a dedicated day of screening in disadvantaged children.
The original article can be found here.