Procedures for the Evaluation of the Visual System by Pediatricians

Donahue, Sean P.; Baker, Cynthia N.

doi:10.1542/peds.2015-3597

Cited by 111 publications

(60 citation statements)

References 21 publications

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“…B: Measures of refractive error from the Spot Photoscreener, whereby the x‐axis is age, and the y‐axis is refraction in dioptres. No children failed according to myopia or hyperopia American Association for Pediatric Ophthalmology and Strabismus (AAPOS) criteria or adjusted AAPOS according to Mu et al; however, six failed for astigmatism (one only according to the adjusted criterion). Participants meeting fail criteria for refraction, acuity or both are highlighted in each panel, and summarised in the legend.…”

Section: Resultsmentioning

confidence: 99%

“…The study protocol consisted of a standardised measure of visual acuity (Lea symbols on a paper chart), photorefraction (Welch Allyn Spot Photoscreener), ocular alignment (unilateral cover test at near), and stereo acuity (Randot preschool). Test procedures followed published guidelines . Our use of the Welch Allyn Spot Photoscreener followed guidelines given in the accompanying manual.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of vision screening of 5–15‐year‐old children in three Tongan schools: comparison of The Auckland Optotypes and Lea symbols

Hamm

Langridge

Black

et al. 2020

Clinical and Experimental Optometry

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Background Comprehensive vision screening programmes for children are an important part of public health strategy, but do not exist in many countries, including Tonga. This project set out to assess: (1) the functional vision of children attending primary schools in Tonga and (2) how a new recognition acuity test (The Auckland Optotypes displayed on a tablet computer) compares to use of a standardised eye chart in this setting. Methods Children from three Tongan primary schools were invited to participate. Acuity testing was conducted using a standardised recognition acuity chart (Lea symbols) and the tablet test displaying two formats of The Auckland Optotypes. Measures of ocular alignment, stereo acuity and non‐cycloplegic photorefraction were also taken. Results Parents of 249 children consented to participate. One child was untestable. Only 2.8 per cent of testable children achieved visual acuity worse than 0.3 logMAR in the weaker eye. Results from the Spot Photoscreener suggested that no children had myopia or hyperopia, but that some children had astigmatism. The tablet test was practical in a community setting, and showed ±0.2 logMAR limits of agreement with the Lea symbols chart. Conclusion The sample of children in Tongan primary schools had good functional vision. A modified version of the tablet acuity test is a promising option for vision screening in this context.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluation of vision screening of 5–15‐year‐old children in three Tongan schools: comparison of The Auckland Optotypes and Lea symbols

Hamm

Langridge

Black

et al. 2020

Clinical and Experimental Optometry

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“…Acuity is a critical measure of visual function for preschool vision screening (Simons, 1996;Cotter et al, 2015), clinical eye care (Donahue & Baker, 2016), and research (Tsirlin, Colpa, Goltz, & Wong, 2015;Guo et al, 2016). Current acuity measurements are limited by test-retest variability (Beck et al, 2003;Rozhkova, Podugolnikova, & Vasiljeva, 2005), patient's familiarity with letters, the ease or difficulty with which individual letters may be recognized (Strong & Woo, 1985;Ferris et al, 1993;Alexander et al, 1997), and for picture optotypes, copyright limitations.…”

Section: Discussionmentioning

confidence: 99%

“…The recommended optotypes for observers who do not know their letters (for example, many preschool children) are a truncated set of Sloan letters (HOTV) or a set of pictograms known as the Lea symbols (Hyvarinen, Nasanen, & Laurinen, 1980;Cotter et al, 2015;Donahue & Baker, 2016). Individual Lea symbols were designed to be similarly legible to one another, have consistent stroke to bounding box ratios (1:7) and close-to-uniform 1:1 aspect ratios.…”

Section: Introductionmentioning

confidence: 99%

The Auckland Optotypes: An open-access pictogram set for measuring recognition acuity

et al. 2018

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When measuring recognition acuity in a research setting, the most widely used symbols are the Early Treatment of Diabetic Retinopathy Study (ETDRS) set of 10 Sloan letters. However, the symbols are not appropriate for patients unfamiliar with letters, and acuity for individual letters is variable. Alternative pictogram sets are available, but are generally comprised of fewer items. We set out to develop an open-access set of 10 pictograms that would elicit more consistent estimates of acuity across items than the ETDRS letters from visually normal adults. We measured monocular acuity for individual uncrowded optotypes within a newly designed set (The Auckland Optotype [TAO]), the ETDRS set, and Landolt Cs. Eleven visually normal adults were assessed on regular and vanishing formats of each set. Inter-optotype reliability and ability to detect subtle differences between participants were assessed using intraclass correlations (ICC) and fractional rank precision (FRP). The TAO vanishing set showed the strongest performance (ICC = 0.97, FRP = 0.90), followed by the other vanishing sets (Sloan ICC = 0.88, FRP = 0.74; Landolt ICC = 0.86, FRP = 0.80). Within the regular format, TAO again outperformed the existing sets (TAO ICC = 0.77, FRP = 0.75; Sloan ICC = 0.65, FRP = 0.64; Landolt ICC = 0.48, FRP = 0.63). For adults with normal visual acuity, the new optotypes (in both regular and vanishing formats) are more equally legible and sensitive to subtle individual differences than their Sloan counterparts. As this set does not require observers to be able to name Roman letters, and is freely available to use and modify, it may have wide application for measurement of acuity.

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“…1 In a 2016 policy statement by the American Academy of Pediatrics, experts indicate that instrument-based vision screening can be attempted beginning at age 12 months. 2 The United States Preventive Services Task Force states, however, that current evidence is insufficient to recommend vision screening in children younger than 3 years of age. 3 …”

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confidence: 99%

Performance of the Spot Vision Screener in Children Younger Than 3 Years of Age

Forcina

Peterseim

Wilson

et al. 2017

American Journal of Ophthalmology

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PURPOSE To evaluate the use of the Spot Vision Screener (Spot; Welch Allyn, Skaneateles Falls, New York, USA) for detection of amblyopia risk factors in children aged 6 months to 3 years, as defined by the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus. DESIGN Reliability analysis. METHODS In this study, children seen from June 1, 2012, to April 30, 2016 were tested with the Spot during a routine visit. Enrolled children underwent a comprehensive eye examination including cycloplegic refraction and sensorimotor testing within 6 months of the testing date by a pediatric ophthalmologist masked to the Spot results. RESULTS A total of 184 children were included. The Spot successfully obtained readings in 89.7% of patients. Compared with the ophthalmologist’s examination, the Spot had an overall sensitivity of 89.8% and a specificity of 70.4%. CONCLUSION The Spot achieved good sensitivity and specificity for detection of amblyopia risk factors in this young cohort, particularly in the older subgroup. Our data offer support for automated vision screening in young children.

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Procedures for the Evaluation of the Visual System by Pediatricians

Abstract: Vision screening is crucial for the detection of visual and systemic disorders. It should begin in the newborn nursery and continue throughout childhood. This clinical report provides details regarding methods for pediatricians to use for screening.

Cited by 111 publications

References 21 publications

Evaluation of vision screening of 5–15‐year‐old children in three Tongan schools: comparison of The Auckland Optotypes and Lea symbols

Evaluation of vision screening of 5–15‐year‐old children in three Tongan schools: comparison of The Auckland Optotypes and Lea symbols

The Auckland Optotypes: An open-access pictogram set for measuring recognition acuity

Performance of the Spot Vision Screener in Children Younger Than 3 Years of Age

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