Photoscreening is a pediatric vision screening technique wherein a camera is used to determine refractive errors and identify risk factors for amblyopia.7

A photoscreener detects amblyopic risk factors such as hyperopia, myopia, and anisometropia and measures their severity.

The Vision Screening Void

The Centers For Disease Control And Prevention (CDC) reports that “vision disability is the single most prevalent disabling condition among children.”¹

Early vision screening is integral to a child’s early health and development, especially in regards to the prevention and treatment of amblyopia, the #1 cause of preventable vision loss in children.²

Regular vision screening assessments in early childhood reduce the risk of persistent amblyopia at 7 years of age by more than 50%.³

However, fewer than 20% of children receive adequate vision screening even though the technology is readily available.4

As a result, “amblyopia remains the most common cause of monocular visual impairment among children.”

Vision Screening at Well Child Visits

Vision screening conducted by pediatricians at annual well child visits often includes a red reflex examination with an ophthalmoscope and a visual acuity test.5

However, examinations with ophthalmoscopes are not sufficient to determine if amblyopic risk factors are present.4

Results that appear normal using an ophthalmoscope may have amblyogenic risk factors, especially if the amblyopia is not strabismic.

Deprivational and refractive amblyopia are much more difficult to find using an ophthalmoscope.

photoscreening can save kid's vision

Although visual acuity is the preferred method for vision screening past the age of 5, studies have shown that there is a 0% positive predictive value for traditional visual acuity testing at 3-4 years of age.5 At this age, children are too young to fully understand a visual acuity test, limiting its effectiveness.

Considering that 15-20% of children have amblyopic risk factors and 3-4% have amblyopia, pediatric practices are lacking a crucial step to effectively screening young children’s vision at well child visits.7

The Solution: Photoscreening for Amblyopia Prevention

Photoscreening is a pediatric vision screening technique wherein a camera is used to determine refractive errors and identify risk factors for amblyopia.7

Photoscreening detects amblyopic risk factors such as hyperopia, myopia, and anisometropia and measures their severity.

If a child is measured as having a high risk for amblyopia, they are referred to a pediatric ophthalmologist or optometrist so they can be tested directly for amblyopia and treated.

Only the screens that present risk factors with severity to make amblyopia likely are referred, in accordance with the American Association for Pediatric Ophthalmologists and Strabismus (AAPOS) guidelines for referral threshold.7

Dr. Sean Donahue, chief of pediatric ophthalmology at Vanderbilt University, summarizes photoscreening well:

“The advent of photoscreening technology provides a mechanism to be used in conjunction with or to supplant traditional ocular examinations with eye charts to detect the risk factors for amblyopia and other treatable refractive errors.

Photoscreening provides a means to perform a quicker and more efficient vision screening than traditional methods.

The availability of handheld photoscreening devices, such as GoCheck Kids, significantly improves the portability, accessibility, and affordability of such devices.”4

How Photoscreening Works

The user, typically an MD, nurse or technician takes a photo of a child.

ocular photoscreening on a smartphone

The user chooses to accept or retake the image.

ocular photoscreening test

Some photoscreeners have the ability to provide immediate results on screen.

photoscreener instant results

The software analyzes the image and identifies asymmetry and anomalies within the red reflex that help determine the child’s risk for amblyopia.

If risk factors are present and they exceed the AAPOS referral guidelines, they will be highlighted in red.

Some photoscreeners even allow results to be faxed directly to an EHR.

Photoscreening is Recommended and Researched

Photoscreening allows pediatricians to catch amblyopic risk factors before a child can comprehend a visual acuity (Snellen chart) test.6

Even in late preschool and kindergarten, one study has the positive predictive value of visual acuity to be only 50%.

This led to excessive false positives and to all true cases of amblyopia being missed.6

For patients ages 1-3, rather than visual acuity testing, photoscreening is now recommended by the American Academy of Pediatrics (AAP), the American Association for Pediatric Ophthalmology and Strabismus, the American Academy of Ophthalmology, and the American Association of Certified Orthoptists.8

The AAP states in their most recent vision policy update, “Instrument-based screening, if available, should be first attempted between 12 months and 3 years of age and at annual well-child visits until acuity can be tested directly…”4

To summarize the AAP recommendations:8

  • Annual photoscreening is now recommended for children beginning at ages 1-3.
  • Visual Acuity Testing is now recommended for children beginning at age 4 when possible.

Photoscreening is on the rise

Photoscreening is becoming a standard of pediatric care. At GoCheck Kids, we now have over 2,800 providers using our photoscreener to prevent permanent vision loss.

Our customers range from pediatric offices in almost every state, to large medical groups spanning multiple states or regions.

Practices Using GoCheck Kids

pediatricians are adopting photoscreeners

Regardless of the size or location of our customers, they all experience that same “Aha” moment the first time they catch a child with significant amblyopic risk factors.

Hearing these stories and knowing our impact has driven us to set an ambitious mission: to screen 20 million kids by 2020.

Here are some of our providers recalling their “Aha” moments:

“The ophthalmologist is hopeful that her amblyopia will diminish. It is likely that GoCheck played a vision-saving role in this child: the patient was only 2 years old at the time of diagnosis. It is likely that her visual defect would not have been discovered until she was old enough to fail a Snellen test, at which point the Amblyopia would have been irreversible.”

-Dr, Phillipa Gordon, Pediatrician

“With an ophthalmoscope, the ‘red reflex’ was equal bilaterally and normal. So without the GoCheck Kids photoscreener – even with my exam – I would have never considered sending this kid for referral.”

-Dr. Kody Findstad, Pediatrician

“GoCheck Kids won over our whole office as each of us had started catching children for the first time.  Every one of our providers has their own story.  Mine was an 18-month-old with severe bilateral amblyopia. Her parents had no idea and we wouldn’t have caught her with traditional techniques.”

-Stephanie Messercold, Pediatric Physician’s Assistant

How many amblyopic patients is your practice missing?

Want to learn even more about photoscreening? Join us at one of our bi weekly webinars that includes:

  • A demonstration of the GoCheck Kids’ photoscreener
  • Discussion on the Economics and Reimbursement around photoscreening
  • Q&A

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