Abstract
BackgroundThis population based cross sectional study was conducted to detect amblyopia risk factors and myopia in a rural district of Northwestern Turkey by using PlusoptiX S12R (Photoscreener PlusoptiX Inc., Nuremberg, Germany).MethodsChildren from 38 rural schools in Caycuma district of Zonguldak Turkey underwent vision screening in their school using PlusoptiX S12 photoscreener. Data were analyzed using the factory default level 5 referral criteria targeting 80% sensitivity and 95% specificity. Referral, unable readings, and positive predictive value (PPV) were reported.ResultsData from 2846 children were analyzed. Mean age was 7.9 years (±0.8) (range 36 months to 11 years). Three hundred ten (11%) were referred of whom 32% were read as ‘unable’. 150 children (48% of the referred) received a gold standard examination. Positive predictive value of PlusoptiX was 69%. PPV was 83% when unable readings were excluded. 93 children with amblyopia risk factors were identified. Only 26% (n = 25) had received glasses priorly. 49 children had amblyopia of whom 33 were newly diagnosed.ConclusionsPlusoptiX showed a reasonable level of positive predictive value in community setting and the device could be a useful tool for vision screening in preschoolers and schoolers. We found most of the amblyogenic refractive errors were underdiagnosed in rural school children leading to a call for action on vision screening.
Highlights
Undiagnosed and untreated vision deficits in children can affect a child’s school performance and life time well-being
Screening was conducted in Caycuma municipiality in collaboration of Zonguldak Governorship who funded the PlusoptiX S12R, Zonguldak Public Health Authority who provided the screening personnel and Bulent Ecevit University Ophthalmology Department who examined the referred children and reviewed the screening images
When unable readings were excluded positive predictive value (PPV) rose to 78%. This is the first report from Turkey on utilization of 4th generation PlusoptiX S12 mobile photoscreener for high volume field testing of refractive errors in schoolers
Summary
Undiagnosed and untreated vision deficits in children can affect a child’s school performance and life time well-being. Amblyopia is the most frequent cause of monocular visual impairment in children and is defined as reduced best- corrected visual acuity in the absence of organic abnormalities accompanied by one or more known amblyopia risk factors, such as strabismus, anisometropia, isoametropia, and cataract [1, 2]. Amblyopia with an estimated prevalence of 2–5% meets all criteria for a World Health Organization screening program based on benefits of diagnosis and treatment [3, 4]. Vision testing (0–6 years) and diagnosis guarantees faster treatment and improvement of amblyopia [5]. This population based cross sectional study was conducted to detect amblyopia risk factors and myopia in a rural district of Northwestern Turkey by using PlusoptiX S12R (Photoscreener PlusoptiX Inc., Nuremberg, Germany)
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