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Vision screening in children by Plusoptix Vision Screener compared with gold-standard orthoptic assessment
  1. A H Dahlmann-Noor1,2,
  2. K Vrotsou3,4,
  3. V Kostakis1,2,
  4. J Brown1,
  5. J Heath1,
  6. A Iron1,
  7. S McGill1,
  8. A J Vivian1,2
  1. 1
    Eye Treatment Centre, West Suffolk Hospital NHS Trust, Bury St Edmunds, UK
  2. 2
    Ophthalmology Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  3. 3
    Centre for Applied Medical Statistics, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Institute of Public Health, Cambridge, UK
  4. 4
    Research Unit, Galdakao Hospital, Bizkaia, Spain
  1. Mr A J Vivian, Eye Treatment Centre, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St Edmunds IP33 2QZ, UK; anthony.vivian{at}


Background/aims: To evaluate a new autorefractor, the Plusoptix Vision Screener (PVS), as a screening tool to detect risk factors for amblyopia by comparing it with gold-standard orthoptic vision screening in children.

Methods: Community-based screening study including 288 children age 4–7 years who were screened with the PVS and by orthoptic assessment (distance acuity, cover test, extraocular movements, 20 PD prism test, Lang stereotest). Follow-up comprehensive eye examination of screening-positive children included manual cycloplegic retinoscopy.

Results: Testability was high for both methods. Orthoptic screening identified 36 children with reduced vision and/or factors associated with amblyopia (referral rate 12.5%). The PVS identified 16 children with potential vision problems (referral rate 5.6%), indicating only moderate sensitivity (44%; 95% CI 27.9 to 61.9%), but high specificity (100%; 95% CI 98.5 to 100%) to detect factors associated with amblyopia. The PVS underestimated visually significant refractive errors.

Conclusions: Use of the PVS as single screening test in young children may miss a significant number of children with amblyopia or amblyogenic risk factors.

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  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by Suffolk Local Research Ethics Committee.

  • Patient consent: Obtained from the parents.

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