Oregon Elks Children's Eye Clinic vision screening results for astigmatism.

BACKGROUND: In the Elks Preschool Vision Screening program, which uses the plusoptiX S12 to screen children 36-60 months of age, the most common reason for over-referral, using the 1.50 D referral criterion, was found to be astigmatism. The goal of this study was to compare the accuracy of the 2.25 D referral criterion for astigmatism to the 1.50 D referral criterion using screening data from 2013-2014.

METHODS: Vision screenings were conducted on Head Start children 36-72 months of age by Head Start teachers and Elks Preschool Vision Screening staff using the plusoptiX S12. Data on 4,194 vision screenings in 2014 and 4,077 in 2013 were analyzed. Area under the curve (AUC) and receiver operating characteristic curve (ROC) analysis were performed to determine the optimal referral criteria. A t test and scatterplot analysis were performed to compare how many children required treatment using the different criteria.

RESULTS: The medical records of 136 (2.25 D) and 117 children (1.50 D) who were referred by the plusoptiX screening for potential astigmatism and received dilated eye examinations from their local eye doctors were reviewed retrospectively. Mean subject age was 4 years. Treatment for astigmatism was prescribed to 116 of 136 using the 2.25 D setting compared to 60 of 117 using the 1.50 D setting.

CONCLUSIONS: In 2013 the program used the 1.50 D setting for astigmatism. Changing the astigmatism setting to 2.25 D; , 85% of referrals required treatment, reducing false positives by 34%.