Performance of the Plusoptix vision screener for the detection of amblyopia risk factors in children

PURPOSE To evaluate the accuracy of the Plusoptix vision screener in detecting amblyopia risk factors in the pediatric population and to determine whether modifying the manufacturer's referral criteria improves the clinical utility of the device. METHODS We compared the rate and pattern with which the Plusoptix vision screener refers a patient for ophthalmic follow-up to the same metric obtained during a complete pediatric ophthalmic examination using AAPOS guidelines. We then modified the manufacturer's criteria in determining which patients would be referred to improve the clinical usefulness of the machine. RESULTS One hundred nine patients were examined. Of these, 53% were found to have amblyopia or amblyopla risk factors. The Plusoptix vision screener referred 67% of these patients, with sensitivity, specificity, positive predictive value, and false-negative rates of 98%, 69%, 78%, and 1.4%, respectively. These same metrics with the modified manufacturer's referral criteria were 98%, 88%, 90%, and 1.5%. CONCLUSIONS The Plusoptix vision screener is a useful tool for the detection of amblyopia risk factors in pediatric populations. Our study shows that the referral criteria can be internally modified to improve both the specificity and positive predictive value of the device without reducing sensitivity in this study group. The Plusoptix vision screener provides an accurate, fast, user-friendly, and portable way to detect amblyopia risk factors. Because the software automatically evaluates the refractive error and ocular alignment and gives a simple referral grade, the Plusoptix screener may offer a reasonable way of providing large-scale vision screenings at relatively low costs.