Agreement and diagnostic accuracy of vision screening in preschool children between vision technicians and spot vision screener

Neha Misra; Rohit C Khanna; Asha Latha Mettla; Srinivas Marmamula; Jill E Keeffe

doi:10.4103/ijo.IJO_1740_19

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ORIGINAL ARTICLE

Year : 2021 | Volume : 69 | Issue : 1 | Page : 117-121

Agreement and diagnostic accuracy of vision screening in preschool children between vision technicians and spot vision screener

Neha Misra¹, Rohit C Khanna², Asha Latha Mettla¹, Srinivas Marmamula³, Jill E Keeffe¹
¹ Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare, L V Prasad Eye Institute, Hyderabad, Telangana, India
² Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
³ Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eyecare; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana; Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute; Department of Biotechnology / Wellcome Trust India Alliance Research Fellow, L V Prasad Eye Institute, Hyderabad, India

Correspondence Address:
Dr. Rohit C Khanna
L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad - 500 034, Telangana

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijo.IJO_1740_19

Purpose: Screening preschool children for vision-related disorders poses a challenge. This study is designed to determine the agreement and diagnostic accuracy of the spot vision screener (SVS) in screening preschool children compared to screening procedure by vision technicians (VT). Methods: This study was conducted as a part of the ongoing study titled “Initiative for Screening Children for Refractive Errors and other Eye Health Needs (I-SCREEN).” Children from 33 Anganwadis (preschools) in two districts, Adilabad district of Telangana and Krishna district of Andhra Pradesh, in South India, underwent eye health screening by a VT and by a trained community eye health workers (CEHW) using the SVS. Findings were compared for agreement and diagnostic accuracy of assessment. Results: A total of 976 preschool children were screened by the VT and separately by the CEHW using the SVS in Adilabad (15 schools) and Krishna (18 schools) districts. The overall mean age of these children was 2.5 years (SD ± 1.3 years). There were 48 (4.9%) referrals by VT compared to 105 (10.8%) referrals by CEHW using SVS. The overall sensitivity of SVS was 91.7% (95% CI: 80%–97.7%) and the specificity was 93.4% (95% CI: 91.6%–94.9%). Positive predictive value was 41.9% (95% CI: 32.3%–51.9%) and negative predictive value was 99.5% (95% CI: 98.8%–99.9%) with a moderate agreement (0.54; 95% CI 0.49–0.64) between VT screening and screening with SVS. Conclusion: The SVS showed good diagnostic accuracy and agreement in screening for possible vision-related disorders in preschool children.

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