An Analysis of the Accuracy and Ease-of-Use of the Most popular Vision Screeners
Most states now mandate Schools to perform a vision screening for all new students enrolled and many require annual or biennial checkups. As School Health Officials and nurses scramble to conform with the recently enacted legislation, the need for an accurate vision screening device is becoming increasingly acute. In this article We take a look at the most commonly used screeners and discuss the conclusions of studies done on the accuracy and use of these devices.
The two main categories of vision screening devices are photoscreeners and auto-refractors.
Photoscreening needs uses light burst technology to detect refractive abnormalities in the fundus. The VIP (Vision in Preschoolers) study (Gui-shuang Ying et al. ROC Analysis of the Accuracy of Noncycloplegic Retinoscopy, Retinomax Autorefractor, and SureSight Vision Screener for Preschool Vision Screening.Invest Ophthalmol Vis Sci. 2011 December; 52(13): 9658–9664) tested these devices and found them accurate. The results need to be interpreted by a professional. Because of this, this type of device has not gained widespread popularity in public health programs.(Children's Eye Foundation, 2012.http://www.childrenseyefoundation.org/index.php/research/types-of-vision-screening-devices)
The three most popular devices used for vision screening of preschoolers are the Noncycloplegic retinoscopy (NCR), the Retinomax Autorefractor (Nikon, Tokyo, Japan), and the SureSight Vision Screener (SureSight, Alpharetta, GA) manufactured by Welch Allyn.
These screeners were calidated in the VIP study to study and compare the accuracy in detecting issues for 3-5 year olds. You can read the study on the PubMed website for more details. The study concluded that all three screeners have a high accuracy rate when set at either 90% or 94%
A closer look at the results of this study reveals that the Retinomax and SureSight Vision Screener tended to have slightly higher accuracy rates when compared to the NCR.
The SureSight has become the device of choice due to its portability, small size, low cost and ease of use. The VIP study group concluded that nurses and lay people were able to achieve similar results when setting the specificity of the device to 90 %.
As a final note, a little anecdote. A nurse called us up recently to order the SureSight. She explained that she was assigned by her school the job of researching a device for their program and concluded that this device was the best for the preschool to kindergarten age group.
The Children's Eye Foundation has a wealth of information and additional links for more information on this and other vision screening devices.
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