200676 Vision Screening for Kindergarten Children: Investigating the Suresight (SS) Autorefractor Alternative

Tuesday, November 10, 2009: 1:15 PM

Stacy A. Lyons, OD , The New England College of Optometry, Boston, MA
Catherine A. Johnson, OD , New England College of Optometry, Boston, MA
Li Deng, PhD , The New England College of Optometry, Boston, MA
Bruce Moore, OD , Marcus Professor of Pediatric Studies, New England College of Optometry, Boston, MA
Katherine Majzoub, RN, MBA , Prevent Blindness America, Boston, MA
Jean E. Ramsey, MD, MPH , Assistant Professor of Ophthalmology and Pediatrics, Boston University School of Medicine, Boston, MA
Arlene Swan-Mahony , Health Services, Boston Public Schools, Dorchester, MA
Purpose: Effective vision screening is important in identifying visual disorders that may impact children throughout their lifetime. The purpose of this study is to compare the sensitivity and specificity of combinations of 3 vision screening tools for detecting vision disorders in kindergarten children. Methods: 457 Boston Public Schools (BPS)kindergarten students were screened by paraprofessionals using the mandated Massachusetts (MA) protocol (MassVAT Lea Symbols and Random Dot E) and a SureSight (SS) autorefractor. All children who did not meet either MA protocol or SS pass criteria along with a matched number who had passed both were referred for a comprehensive eye exam by pediatric optometrists. The exam identified targeted conditions as defined previously by the Vision In Preschoolers Study Group. Primary outcome measures were the sensitivity and specificity of each tool or tool combination for detecting targeted vision disorders. Results: 131 children failed their screening, while 154 were consented and received the exam. Sensitivities and specificities for detecting targeted conditions were significantly better when using the SS + MassVAT (81% and 88%, respectively) compared to other tool combinations. Conclusions: Relative to the mandated MA protocol (60%), vision screening using SS autorefraction in combination with MassVAT Lea visual acuity (81%) yields a considerable improvement in the detection of targeted vision disorders in kindergarten children. This is true even when performed in “real world” screening environments by minimally trained screeners who would typically be responsible for completing school based screenings. This combined protocol should be considered as an alternative for kindergarten vision screening.

Learning Objectives:
1) Discuss the ways that untreated visual disorders may impact children throughout their lifetime, especially in terms of academic achievement. 2) Contrast the sensitivity and specificity of the mandated Massachusetts school vision screening regimen with a protocol combining the MA regimen with the Suresight autorefractor.

Keywords: Pediatrics, Vision Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Associate Professor, New England COllege of Optometry
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.