Application of the SpotTM Vision Screener in Strabismus Screening in Children

Abstract

Objective: To explore the effectiveness of the Spot vision screener in detecting childhood strabismus amblyopia risk factors (ARFs). Methods: In this cross-sectional study, 389 children (mean age±standard deviation, 6.0±2.3 years) were recruited from July to October 2015 at Department of Health Care, He Ping New Century International Women and Children's Hospital, these children were tested with the Spot vision screener prior to examination by a pediatric ophthalmologist. The screener refers children for strabismus based upon the measurement of gaze by the device. We compared the results of screening by the automated screener and by the pediatric ophthalmologist examination. Based upon the comparison, we determined the sensitivity, specificity, positive predictive value, and negative predictive value of the automated screener in detecting strabismus ARFs according to the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) vision screening committee referral guidelines. Results: Ten children could not participate automated screening, among them, seven children due to the presence of ocular pathology. Of the remaining 379 children (97.4%), the Spot vision screener referred 49 children (12.6%) for strabismus, while 38 (9.8%) were referred by the pediatric ophthalmologist. The Spot vision screener sensitivity was 71.0%, the specificity was 93.7%, the positive predictive value was 55.3%, and the negative predictive value was 96.8% in detecting strabismus ARFs. Conclusions: The Spot vision screener provided clinical data on a greater percentage of children than did the pediatric ophthalmologist. The Spot vision screener is a useful device in strabismus ARFs screening. Key words: amblyopia risk factor; strabismus; screening