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. 2017 Dec 4;17(1):232.
doi: 10.1186/s12886-017-0624-y.

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

Maya Tsao Wu  1 , M Diane Armitage  1 , Claire Trujillo  1 , Anna Trujillo  1 , Laura E Arnold  1 , Lauren Tsao Wu  1 , Robert W Arnold  2
Affiliations

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

Maya Tsao Wu et al. BMC Ophthalmol. .

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.

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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
See this image and copyright information in PMC

References

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