Portable acuity screening for any school: validation of patched HOTV with amblyopic patients and Bangerter normals

Maya Tsao Wu, M Diane Armitage, Claire Trujillo, Anna Trujillo, Laura E Arnold, Lauren Tsao Wu, Robert W Arnold, Maya Tsao Wu, M Diane Armitage, Claire Trujillo, Anna Trujillo, Laura E Arnold, Lauren Tsao Wu, Robert W Arnold

Abstract

Background: We needed to validate and calibrate our portable acuity screening tools so amblyopia could be detected quickly and effectively at school entry.

Methods: Spiral-bound flip cards and download pdf surround HOTV acuity test box with critical lines were combined with a matching card. Amblyopic patients performed critical line, then threshold acuity which was then compared to patched E-ETDRS acuity. 5 normal subjects wore Bangerter foil goggles to simulate blur for comparative validation.

Results: The 31 treated amblyopic eyes showed: logMAR HOTV = 0.97(logMAR E-ETDRS)-0.04 r2 = 0.88. All but two (6%) fell less than 2 lines difference. The five showed logMAR HOTV = 1.09 ((logMAR E-ETDRS) + .15 r2 = 0.63. The critical-line, test box was 98% efficient at screening within one line of 20/40.

Conclusion: These tools reliably detected acuity in treated amblyopic patients and Bangerter blurred normal subjects. These free and affordable tools provide sensitive screening for amblyopia in children from public, private and home schools. Changing "pass" criteria to 4 out of 5 would improve sensitivity with somewhat slower testing for all students.

Conflict of interest statement

Ethics approval and consent to participate

The Alaska Blind Child Discovery project obatained IRB approval from Providence Hospital for ongoing, observational study of non-invasive objective and sensory vision screening methods. Study is HIPAA compatible with HIPAA and the Declarations of Helsinki. Parents and legal guardians for patients in this study gave written, informed consent.

Consent for publication

School nurses, and parents of Fig. 1 gave consent to share the image for the purpose of education.

Competing interests

Alaska Blind Child Discovery has received discounted vision screening technology from several vendors. Dr. Arnold is an investigator and protocol developer for PEDIG. No author or ABCD receives royalties from Precision Vision.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Alaskan school nurse using the ABCD surround, HOTV flip card critical line with matching card on a child wearing a “No Peeking Eye Patch” to assure sensitive, monocular visual acuity screening. Ten foot (3 meter) testing distance assured by accompanying beaded cord- on the floor
Fig. 2
Fig. 2
Free, downloadable folded surround HOTV test boxes and matching card with instructions
Fig. 3
Fig. 3
Surround HOTV logMAR acuity versus E-ETDRS logMAR acuity in 31 amblyopic patients
Fig. 4
Fig. 4
Surround HOTV logMAR acuity versus E-ETDRS logMAR acuity in normal subjects with blur induced by Bangerter foil swim goggles
Fig. 5
Fig. 5
Receiver-operator characteristic (ROC) curve for surround HOTV flip card and test box screening in amblyopic patients and in Bangerter foil blurred normal subjects. Amblyopia is defined as E-ETDRS visual acuity of 20/40 or worse. Points on the curve correspond to passing that given level of HOTV visual acuity with at least 3 of 4 correct

References

    1. Longmuir SQ, Pfeifer W, Shah SS, Olson R. Validity of a layperson-administered web-based vision screening test. J AAPOS. 2015;19(1):29–32. doi: 10.1016/j.jaapos.2014.10.021.
    1. Leman RE, Clausen MM, Bates J, Stark L, Arnold KK, Arnold RW. A comparison of patched HOTV visual acuity and photoscreening. J Sch Nurs. 2006;22(4):237–243. doi: 10.1177/10598405050220040901.
    1. Clausen MM, Armitage MD, Arnold RW. Overcoming barriers to pediatric visual acuity screening through education plus provision of materials. J AAPOS. 2009;13(2):151–154. doi: 10.1016/j.jaapos.2008.10.018.
    1. Birch EE, Strauber SF, Beck RW, Holmes JM. Comparison of the amblyopia treatment study HOTV and the electronic-early treatment of diabetic retinopathy study visual acuity protocols in amblyopic children aged 5 to 11 years. J AAPOS. 2009;13(1):75–78. doi: 10.1016/j.jaapos.2008.07.007.
    1. Moke PS, Turpin AH, Beck RW, et al. Computerized method of visual acuity testing: adaptation of the amblyopia treatment study visual acuity testing protocol. Am J Ophthalmol. 2001;132(6):903–909. doi: 10.1016/S0002-9394(01)01256-9.
    1. Cotter SA, Chu RH, Chandler DL, et al. Reliability of the electronic early treatment diabetic retinopathy study testing protocol in children 7 to <13 years old. Am J Ophthalmol. 2003;136(4):655–661. doi: 10.1016/S0002-9394(03)00388-X.
    1. Miller JM, Lessin HR, AAP Instrument-based pediatric vision screening policy statement. Pediatrics. 2012;130(5):983–986. doi: 10.1542/peds.2012-2548.
    1. Silbert DI, Matta NS, Brubaker A. Flip chart visual acuity screening for Amblyopia risk factors compared to the PlusoptiX A09 Photoscreener,Tests performed by a lay screener. Binocul Vis Strabolog Q Simms-Romano. 2013;28(4):222–228.
    1. Perez GM, Archer SM, Artal P. Optical characterization of Bangerter foils. Invest Ophthalmol Vis Sci. 2010;51(1):609–613. doi: 10.1167/iovs.09-3726.
    1. Shah N, Laidlaw D, Rashid S, Hysi P. Validation of printed and computerized crowded Kay picture logMAR test against gold standard ETDRS acuity test chart measurements in adult and amblyopic paediatric subjects. Eye (London) 2012;26(4):593–600. doi: 10.1038/eye.2011.333.
    1. VIPS Effect of age using lea Symbons or HOTV for preschool vision screening. Optom Vis Sci. 2010;87(2):87–95. doi: 10.1097/OPX.0b013e3181c750b1.
    1. Mitsuyu M, Zimmer EM. Bangerter occlusives versus spherical convex lenses in the evaluation of visual acuity by visually evoked cortical potentials. Dev Ophthalmol. 1984;9:115–122. doi: 10.1159/000409813.
    1. Rutstein RP, Foster NC, Cotter SA, et al. Visual acuity through Bangerter filters in nonamblyopic eyes. J AAPOS. 2011;15(2):131–134. doi: 10.1016/j.jaapos.2010.11.015.
    1. Rutstein RP, Quinn GE, Lazar EL, et al. A randomized trial comparing Bangerter filters and patching for the treatment of moderate amblyopia in children. Ophthalmology. 2010;117(5):998–1004. doi: 10.1016/j.ophtha.2009.10.014.
    1. Odell NV, Leske DA, Hatt SR, Adams WE, Holmes JM. The effect of Bangerter filters on optotype acuity, Vernier acuity, and contrast sensitivity. J AAPOS. 2008;12(6):555–559. doi: 10.1016/j.jaapos.2008.04.012.
    1. Cotter SA, Cyert LA, Miller JM, Quinn GE. National Expert Panel to the National Center for Children's V, eye H. Vision screening for children 36 to <72 months: recommended practices. Optom Vis Sci. 2015;92(1):6–16. doi: 10.1097/OPX.0000000000000429.

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