ICheckKids, SPOT, iScreen, and Plusoptix performance in a high-risk, young pediatric eye practice

Abstract

Practical pediatric objective screening devices have improved at the same time the 99174 procedure code came into use. Pediatricians, concerned with practicality and validity, are asking “Which photoscreener should we get?” A new addition by iCheckHC makes use of an iPhone with software to over-ride the red-eye reduction preflash and collect patient data. Consecutive young patients in a pediatric eye practice had comprehensive exams and four state-of-the-art photoscreeners (iScreen, Pediavision SPOT, Plusoptix A09 and iCheckKids) consistent with the 2003 AAPOS Vision screen Amblyopia Risk Factor guidelines. 96 patients aged 6-130 months (mean 46 months) had prescreening probability 53%. The Sensitivity/specificity for each was: iScreen 78%/92%, SPOT 77%/87%, Plusoptix 83%/90% and the iCheckKids with DCC interpretation: 80%/93%. Additional statistics highlight the impact of inconclusive screen interpretations. These devices performed well. Each device has advantages with adjustable interpretation by Plusoptix and SPOT, rapid aim and image with online interpretation with iScreen and hand-held portability with iCheckKids. All devices are expected to improve with enhanced interpretation paradigms. Additional validation efforts include pediatric offices and community screening. Recent developments in devices and interpretation promise to improve early screening for amblyopia.