Effectiveness of the Spot Vision Screener in screening 3-year-old children with potential amblyopia in Japan

Purpose The purpose of this study was to compare the efficiency of conventional screening and of the Spot (TM) Vision Screener (SVS)-based screening in detecting potential cases of amblyopia during the Visual examination in Three-Year-Old Health Screening Program (VTYOS), that need to be referred for comprehensive examination. Study Design Population-based cross-sectional study Methods This study introduced the SVS-based test to the VTYOS (which includes primary, secondary, and comprehensive examinations) of Sagae, Yamagata Prefecture, Japan. Children aged 3 years 6 months scheduled to undergo the secondary examination were subjected to both the SVS-based (evaluation of refractive error and eye alignment) and conventional screening test (questionnaire and visual acuity evaluation). Success rates, proportion of children who needed a comprehensive examination, rates of actual comprehensive examinations, and positive predictive value were determined and compared between conventional screening and SVS-based screening. Results There were 294 participants; the rate of success of SVS-based screening (99.7%) was higher than conventional screening (89.5%, p < 0.01). The proportion of participants found to need a comprehensive examination according to SVS-based findings (7.5%) was lower than that according to conventional screening-based findings (23.5%, p < 0.01). The positive predictive value of the SVS-based screening test (75.0%) was higher than that of the conventional screening test (31.6%, p < 0.01). SVS-based screening detected 2 cases of amblyopia in 225 cases that passed conventional screening. Conclusion The VTYOS should ideally add SVS-based screening to conventional screening.