Predictive value of inexpensive digital eye and vision photoscreening: "PPV of ABCD".

PURPOSE: Some consumer digital cameras have short flash to lens distances (dimensions) ideal for photoscreening so we adopted them into an ongoing Alaska state wide vision screening program, the Alaska Blind Child Discovery (ABCD) Project.

METHODS: Digital cameras with short flash-lens distance were employed by lay screeners trained by a DVD movie. Confirmatory eye examinations by AAPOS (American Association for Pediatric Ophthalmology and Strabismus) criteria were sought from eye doctors.

RESULTS: 2900 children were screened in 62 clinics by 14 screeners. Of the 2900 screenings, 99% were readable with 6% refereed as positive for ocular pathology. The positive predictive value was estimated as greater than 80%. The per-screening image cost was less than $0.10 (10 cents) including cameras. Some screeners interpreted images similar to central reading center.

CONCLUSION: Pre-literate community eye and vision photoscreening can be both valid and cost effective.