VISION SCREENING IN PRIMARY CARE – It is time to get onboard

BY DAVID BROTTMAN, MD

 

“Really? Now we should photoscreen all kids over the age of 1 year? What else can they put on us.” That was my first thought when the American Academy of Pediatrics, the American Academy of Ophthalmology, and the American Optometric Association updated their screening policy statements in 2015 to include recommending photoscreening for children ages 1 to 3.

After our group of five independent pediatricians calmed down and thought about the idea, however, we realized that this new technology was probably far superior to the old methods we employed to screen vision. We researched the available products, seeking the tool that would accomplish screening with the highest specificity and sensitivity. The tools varied in cost and sophistication from cell phone apps to more expensive screening devices. We collected data on the options and presented it to the optometrists and pediatric ophthalmology groups to whom we refer. We asked them, which of these products would you want us to use on your child? They understand that over- and under-referrals are real issues in our community, and they want to prevent them as much as we do. They all picked Plusoptix.Screen Shot 2018-03-26 at 3.19.52 PM

When we demoed the products available, we found that, across the board, the Plusoptix vision screener was a perfect fit for our practice. We could integrate it into our electronic health records easily, as the unit creates a pdf of the Report. It was easy to use and maintain and the pass-through cost to the patient was affordable.

Screening report_Refer_EN_mit Rahmen
Letter-sized PDF screening report

 

After more than a year, we have found it to be a simply fantastic addition to our practice. We are uncovering more vision problems sooner, and the feedback from our ophthalmology colleagues has been extremely positive.

We can pick up myopia much earlier, enabling us to refer patients for treatments like orthokeratology years earlier than we could previously. You might think this is overkill, “I know how to use an ophthalmoscope,” you are thinking. Doctors can often be victims of their own egos; we think we are good at our job, and we believe we are not missing any conditions. Think about how many folks you refer to a specialist for a failed vision screen in your office. Now, compare those numbers with the statistics below.

20 Prozent der Kinder_Grafik_englisch

In the United States, 20% of children have risk factors that may lead to amblyopia if they are not treated.1 According to Prevent Blindness, 3% of children younger than 18 are visually impaired, defined as having trouble seeing even when wearing glasses or contact lenses, or even blind. The prevalence of amblyopia is 2% of 6- to 72-month-old children, and it is the most common cause of vision loss in this population.1

In our practice, I can tell you that the ophthalmology colleagues we have always referred to have been amazed at what we have uncovered with Plusoptix. It is quite amazing how much better this technology is compared to what we thought we were doing well before.

According to a recent study, the Plusoptix S12 – Vision Screener outperformed two other devices as an autorefractor, particularly with respect to astigmatism power and axis 2 The sensitivity of the Plusoptix device in this case was 91% and the specificity was 71%.

 

  1. Prevent Blindness. https://www.preventblindness.org/content/prevalence-and-impact-vision-disorders-us-children. Accessed March 10, 2018.
  2. Kirk SArmitage MDDunn SArnold RW. Calibration and validation of the 2WIN photoscreener compared to the PlusoptiX S12 and the SPOT. J Pediatr Ophthalmol Strabismus.2014;51(5):289-92.

 

 Check out Plusoptix online or drop me an email if you have any questions: drb@arlingtonpediatrics.com.

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