Strabismus, Early Online, 1–4, 2014 ! Informa Healthcare USA, Inc. ISSN: 0927-3972 print / 1744-5132 online DOI: 10.3109/09273972.2014.904896 Comparing the SureSight autorefractor and the plusoptiX photoscreener for pediatric vision screening David Silbert, MD, FAAP 1 , Noelle Matta, CO, CRC, COT 1 , Jing Tian, MS 2 , and Eric Singman, MD, PhD 3 1 Vision Science Department, Family Eye Group, Harrisburg Pike, Lancaster, USA, 2 Department of Biostatistics, Biostatistics Consulting Center, Baltimore, USA, and 3 Wilmer Eye Institute, Baltimore, USA ABSTRACT Purpose: Both the plusoptiX photoscreener photoscreener and the SureSight autorefractor can be used to objectively screen for amblyogenic risk factors in children. We compare the plusoptiX and the SureSight to a pediatric ophthalmology examination on a single cohort of children. Methods: We performed a retrospective medical records review of 90 children. Each patient was screened with both the PlusoptiX A09 and SureSight devices on the same day as part of a comprehensive pediatric ophthalmic examination. The ages of the patients ranged from 5 1 to 17 years. All patients had a cycloplegic refraction on the day of their exam, or within the previous 6 months. Results: Of the children reviewed, 71% had amblyopia risk factors. The plusoptiX demonstrated a sensitivity of 98% and a specificity of 88%. The SureSight demonstrated a sensitivity of 95% and a specificity of 65% utilizing the manufacturer’s criteria. Conclusion: The SureSight and plusoptiX were both found to be reliable objective vision screening devices, though the plusoptiX did have a higher sensitivity and specificity than the SureSight using the manufacturer’s referral criteria. Using the Vision In Preschoolers Study (VIPS) referral criteria, the specificity of the SureSight improved but the sensitivity was reduced. Keywords: Amblyopia, pediatric, photoscreening, plusoptiX, strabismus, SureSight, vision screening/ diagnosis, vision screening INTRODUCTION While a number of FDA-approved vision screening devices are currently available, few of them have been directly compared on the same cohort of children. This information would be helpful in guiding decisions of community-based vision screening programs. We have previously reported our results comparing the plusoptiX S04 photoscreener against the MTI photoscreener as interpreted by an expert masked examiner 1 to detect American Association for Pediatric Ophthalmology and Strabismus (AAPOS)-defined amblyopia risk factors. In this study we sought to determine how well the SureSight, a battery-powered autorefractor that can be used as a vision screener, performs versus the plusoptiX A09 photoscreener on the same cohort of children compared to a gold-standard pediatric ophthalmol- ogy examination. The plusoptiX A09 is a noninvasive, binocular, infrared photoscreener and autorefractor. It has a testing distance of 1 meter, attracting the child’s attention with sounds and an image of a smiling face. The device estimates noncycloplegic refractive error, pupil size, and gaze deviation. It provides immediate interpretation and can be programmed to use various referral criteria. Although the A09 (and a similar device, the S09) have been studied less extensively than the S04, all plusoptiX photoscreeners employ similar mechanics and perform interchangeably with the S04. 2 The SureSight autorefractor is a noninvasive, handheld, monocular autorefractor with a testing Correspondence: Noelle S Matta, Family Eye Group, Vision Science, 2110 Harrisburg Pike, Lancaster, 17601 United States, E-mail: noellematta@gmail.com Received 11 March 2013; Revised 23 August 2013; Accepted 5 March 2014; Published online 16 April 2014 1 Strabismus Downloaded from informahealthcare.com by 66.109.227.166 on 04/17/14 For personal use only.