PPV (%): 70.4 75.2 82.2 73.8 85.4 77.3 Traditional and Instrument-Based Vision Screening in Third-Grade Students Evan Silverstein, MD; Elaine R. McElhinny, MD Department of Ophthalmology Virginia Commonwealth University, Richmond, VA References: 1 Sean P. Donahue, Brian Arthur, Daniel E. Neely, Robert W. Arnold, David Silbert, James B. Ruben, Guidelines for automated preschool vision screening: A 10-year, evidence-based update. JAAPOS 2013;17:4-8. 2 April A. Salcido, Joel Bradley, Sean P. Donahue. Predictive Value of Photoscreening and Traditional Screening of Preschool Children. JAAPOS;9:114-120. Introduction: AAPOS recommends optotype-based vision screening for children >5 years old. 1 Instrument-based screening for 3-4 year olds are more time-efficient and have higher positive predictive value than traditional optotype screening. 2 This study evaluates instrument-based vision screening and traditional screening for third-grade students. Methods: Third-graders from 16 schools in a single county in Virginia were screened by traditional methods (optotypes and stereoacuity) and Plusoptix S12. Children referred from either method received a comprehensive eye examination with cycloplegic refraction in the schools (MD/OD). Time to screen was recorded. Conclusion: Instrument-based vision screening is more time efficient than traditional screening and has a similar PPV in third-grade students. Input from teachers to identify struggling students may be helpful if students are screened solely with autorefractors or photoscreeners. 169 169 229 118 0 100 200 300 400 500 600 Total Referred 87 87 98 54 0 20 40 60 80 100 120 140 160 180 200 Examinations 74 74 57 32 < 20/30 VA 80 80 72 24 Glasses Prescribed 82 82 76 27 Intervention* 22 22 20 4 Amblyopia *glasses or referral for more in-depth exam Results: Screened: 1593 children. Referred: 516(32.4%). Examined: 247(47.9%). Discussion: The Plusoptix has similar PPV to traditional vision screening and detects children with acceptable visual acuity but may have a need for glasses. Children with non-refractive decreased visual acuity may be missed by instrument- based screens. Time to screen (average) Plusoptix 30 seconds Traditional 120 seconds Traditional Only Plusoptix Only Total 54 98 Intervention* 27 (50%) 75 (76.5%) Non-refractive 8 + 2 Prescribed Rx 4 16 Characteristics of children with examinations that are referred by only one method. + visual acuity ranged 20/50 – 20/100 after manifest refraction No statistical significance between PPVs. P < 0.01

Traditional and Instrument -Based Vision Screening in Third-Grade … · PPV (%): 70.4 75.2 82.2 73.8 85.4 77.3 Traditional and Instrument -Based Vision Screening in Third-Grade Students

Download PDF Report

Upload
others
View
3
Download
0

Embed Size (px)

Citation preview

PPV (%): 70.4 75.2 82.2 73.8 85.4 77.3

Traditional and Instrument-Based Vision Screening in Third-Grade Students

Evan Silverstein, MD; Elaine R. McElhinny, MD Department of Ophthalmology Virginia Commonwealth University, Richmond, VA

References: 1 Sean P. Donahue, Brian Arthur, Daniel E. Neely, Robert W. Arnold, David Silbert, James B. Ruben, Guidelines for automated preschool vision screening: A 10-year, evidence-based update. JAAPOS 2013;17:4-8.2 April A. Salcido, Joel Bradley, Sean P. Donahue. Predictive Value of Photoscreening and Traditional Screening of Preschool Children. JAAPOS;9:114-120.

Introduction: AAPOS recommends optotype-based vision screening for children>5 years old.1 Instrument-based screening for 3-4 year olds are more time-efficientand have higher positive predictive value than traditional optotype screening.2 Thisstudy evaluates instrument-based vision screening and traditional screening forthird-grade students.

Methods: Third-graders from 16 schools in a single county in Virginia werescreened by traditional methods (optotypes and stereoacuity) and Plusoptix S12.Children referred from either method received a comprehensive eye examinationwith cycloplegic refraction in the schools (MD/OD). Time to screen was recorded.

Conclusion: Instrument-based vision screening is more time efficient thantraditional screening and has a similar PPV in third-grade students. Input fromteachers to identify struggling students may be helpful if students are screenedsolely with autorefractors or photoscreeners.

169 169

229118

100

200

300

400

500

600

Total Referred

87 87

9854

100

120

140

160

180

200

Examinations

74 74

5732

< 20/30 VA

80 80

7224

Glasses Prescribed

82 82

7627

Intervention*

22 2220 4

Amblyopia

*glasses or referral for more in-depth exam

Results: Screened: 1593 children. Referred: 516(32.4%). Examined: 247(47.9%).

Discussion: The Plusoptix has similar PPV to traditional vision screening anddetects children with acceptable visual acuity but may have a need for glasses.Children with non-refractive decreased visual acuity may be missed by instrument-based screens.

Time to screen (average)

Plusoptix 30 seconds

Traditional 120 seconds Traditional Only Plusoptix Only

Total 54 98

Intervention* 27 (50%) 75 (76.5%)

Non-refractive 8+ 2

Prescribed Rx 4 16

Characteristics of children with examinations that are referred by only one method.

+ visual acuity ranged 20/50 – 20/100 after manifest refraction

No statistical significance between PPVs.

P < 0.01