Diagnosis accuracy of two vision screeners for visual health surveillance of workers who use video display terminals

Abstract

Objective: To compare the diagnostic accuracy of two vision screeners by a visual examination performed by an optometrist (gold standard) and to evaluate the concordance between both screeners and between each screener and the gold standard. Methods: This was a cross-sectional study that included computer workers who attended a routine yearly health examination. The study included administrative office workers (n=91) aged 50.2±7.9 years (mean±standard deviation), 69.2% of whom were women and 68.1% of whom used video display terminals (VDT) for >4 h/day. The routine visual examination included monocular and binocular distance visual acuity (VA), distance and near lateral phoria (LP), stereo acuity (SA), and color vision. Tests were repeated with Optec 6500 (by Stereo Optical) and Visiotest (by Essilor) screeners. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and false positive and negative rates were calculated. Kappa coefficient (κ) was used to measure the concordance of the screeners and the gold standard. Results: The sensitivity and specificity for monocular VA were over 80% for both vision screeners; PPV was below 25%. Sensitivity and specificity were lower for SA (55%-70%), PPV was 50%, and NPV was 75% for both screeners. For distance LP, sensitivity and PPV were <10% in both cases. The screeners differed in their values for near LP: Optec 6500 had higher sensitivity (43.5%), PPV (37.0%), and NPV (79.7%); whereas the Visiotest had higher specificity (83.8%). For color vision, Visiotest showed low sensitivity, low PPV, and high specificity. Visiotest obtained false positive rates that were lower or similar to Optec 6500, and both screeners obtained false negative rates below 50%. Both screeners showed poor concordance (κ<0.40). Conclusions: A high value for NPV would qualify both screeners as acceptable alternatives for visual health surveillance when used as a screening tool; patients with positive test results should be referred to a specialist.

A review of vision screening methods for children

“…Stereoscopes such as the Visiotest, Optec and Ergovision are recommended vision screeners regarded as fast with low maintenance costs; they are used in most European countries such as France and England. 58 In their study, Horberry et al 59 found the Titmus 2, Keystone VS-II and Optec 2500 results for vision screening to be close to those found in the gold standard visual examinations performed by optometrists. The use of stereoscopes as a vision screening method for children of schoolgoing age is still a subject of debate.…”

Clinical Utility of the DriveFocus™ Intervention on Young Drivers With and Without Experience

“…Participants completed a validated battery (Table 1) of clinical assessments appropriate for this population (18). The OPTEC 2500 visual analyzer, a sensitive and specific screening tool for visual health (19) was used to assess seven visual skills: visual acuity, peripheral field of view, color discrimination, depth perception, lateral phorias, vertical phorias, and contrast sensitivity. Visual-motor integration was measured via the Beery-Buktenica Developmental Test of Visual-Motor Integration [Beery VMI™; (20)], a valid and reliable norm referenced test of visual motor integration (20).…”

Cross-sectional study assessing the addition of contrast sensitivity to visual acuity when testing for fitness to drive

“…Monocular and binocular distance VA were measured using a vision screener called Visiotest (manufacturer Essilor). This device has been shown to have a sensitivity of 100% and a specificity of 88.1% 27 to detect vision deficiency compared with an examination of vision carried out by an optometrist. Luminosity was set to 320 cd/m 2 with optotype contrast close to 100%.…”