• Artificial intelligence
• Autorefractor
• Ophthalmology
• Optics
• Refractive errors
• Retinoscopy

• amblyopia
• anisometropia
• refractive error
• spot vision screener
• strabismus

• Amblyopia risk factors
• Children
• Cycloplegia
• Refractive error
• Spot vision screener

• Humans
• Amblyopia/diagnosis
• Child, Preschool
• Child
• Male
• Female
• Risk Factors
• Mydriatics/administration & dosage
• Vision Screening/instrumentation
• Vision Screening/methods
• Sensitivity and Specificity
• ROC Curve
• Refractive Errors/diagnosis
• Practice Guidelines as Topic
• Predictive Value of Tests

• Child
• Humans
• Amblyopia/diagnosis
• Amblyopia/epidemiology
• Sensitivity and Specificity
• Down Syndrome/complications
• Down Syndrome/diagnosis
• Predictive Value of Tests
• Physical Examination
• Vision Screening/methods
• Risk Factors
• Refractive Errors/diagnosis
• Reproducibility of Results

• anthropometric indicators
• associations
• myopia
• refraction
• school-age children

• Accommodative spasm
• photoscreeners
• pseudo-myopia

• Preschool children
• referral accuracy
• spot vision screener
• vision screening

Is home confinement due to coronavirus disease 2019 associated with the burden of myopia?

In this cross-sectional study that included 194 904 photoscreening tests conducted in 123 535 children, a substantial myopic shift (−0.3 diopters) was noted after home confinement due to coronavirus disease 2019 for children aged 6 to 8 years. The prevalence of myopia increased 1.4 to 3 times in 2020 compared with the previous 5 years.

Home confinement due to coronavirus disease 2019 appeared to be associated with a substantial myopic shift in children; younger (aged 6-8 years) children’s refractive status may be more sensitive to environmental changes than older children, given that they are in an important period for the development of myopia.

Time spent in outdoor activities has decreased owing to home confinement for the coronavirus disease 2019 (COVID-19) pandemic. Concerns have been raised about whether home confinement may have worsened the burden of myopia owing to substantially decreased time spent outdoors and increased screen time at home.

To investigate the refractive changes and prevalence of myopia in school-aged children during the COVID-19 home confinement.

A prospective cross-sectional study using school-based photoscreenings in 123 535 children aged 6 to 13 years from 10 elementary schools in Feicheng, China, was conducted. The study was performed during 6 consecutive years (2015-2020). Data were analyzed in July 2020.

Noncycloplegic photorefraction was examined using a photoscreener device.

The spherical equivalent refraction was recorded for each child and the prevalence of myopia for each age group during each year was calculated. The mean spherical equivalent refraction and prevalence of myopia were compared between 2020 (after home confinement) and the previous 5 years for each age group.

Of the 123 535 children included in the study, 64 335 (52.1%) were boys. A total of 194 904 test results (389 808 eyes) were included in the analysis. A substantial myopic shift (approximately −0.3 diopters [D]) was found in the 2020 school-based photoscreenings compared with previous years (2015-2019) for younger children aged 6 (−0.32 D), 7 (−0.28 D), and 8 (−0.29 D) years. The prevalence of myopia in the 2020 photoscreenings was higher than the highest prevalence of myopia within 2015-2019 for children aged 6 (21.5% vs 5.7%), 7 (26.2% vs 16.2%), and 8 (37.2% vs 27.7%) years. The differences in spherical equivalent refraction and the prevalence of myopia between 2020 and previous years were minimal in children aged 9 to 13 years.

Home confinement during the COVID-19 pandemic appeared to be associated with a significant myopic shift for children aged 6 to 8 years according to 2020 school-based photoscreenings. However, numerous limitations warrant caution in the interpretation of these associations, including use of noncycloplegic refractions and lack of orthokeratology history or ocular biometry data. Younger children’s refractive status may be more sensitive to environmental changes than older ages, given the younger children are in a critical period for the development of myopia.

• accuracy
• astigmatism
• autorefractor
• emmetropia
• myopia
• photorefraction
• repeatability
• screening
• wavefront aberrations

• Amblyopia/diagnosis
• Amblyopia/epidemiology
• Child
• Cross-Sectional Studies
• Female
• Humans
• Male
• Portugal/epidemiology
• Prevalence
• Quality of Life
• Retrospective Studies
• Risk Factors
• Vision Screening/methods
• Visual Acuity

• India
• Odisha
• refractive error
• school children
• tribal district

• Children
• Epidemiology
• Myopia
• Photoscreen
• Refractive error
• Visual acuity

• Amblyopia
• Amblyopie
• Dépistage visuel
• Photoscreening
• Refraction
• Réfraction
• Spot Vision Screener
• Visual screening

To evaluate the accuracy of Spot photoscreener (PS) as a noncycloplegic photorefractor in detecting amblyopia risk factors (ARFs) in preschool children in an Indian eye clinic setting. Also, to derive appropriate cutoff values for screening to obtain maximum sensitivity and specificity of the device in detecting ARF.

This was a cross-sectional study conducted in the outpatient pediatric eye clinic at a tertiary eye care institute. A Spot PS was used to screen all the children between the ages of 6 months and 5 years that presented to the eye clinic from August 2018 to October 2018. This screening was followed by a complete eye examination, including cycloplegic refraction by a masked examiner. The 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines were considered the standard cutoff values for clinically significant refractive error in children younger than 5 years of age.

The study comprised of 219 children. The Spot PS diagnosed 135 (61.64%) children with ARF as compared with 124 (56.62%) children detected by clinic examination. For ARF detection, the Spot photoscreeneer had 85.48% sensitivity, 69.47% specificity, 78.52% positive predictive value and 78.57% negative predictive value. The sensitivity for detection of strabismus and hypermetropia was very low (42% and 36%, respectively). The 95% limits of agreement ranged from −5.48 to +5.59 diopters (D) with a bias of 0.06 D for spherical equivalent between noncycloplegic photorefraction and cycloplegic refraction.

The Spot PS may be used as a screening tool to detect ARF in children younger than 5 years of age keeping its limitations in consideration. However, the performance can be improved by modifying the cutoff values for the referral.

• Amblyopia
• cyclorefraction
• photoscreener

• Plusoptix
• Spot
• amblyopia risk factors
• children
• meta-analysis
• photoscreener
• refractive error
• sensitivity
• specificity

To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses.

The Spot's sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%.

The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

• Photorefraction
• school
• vision screening

• Adolescent
• Child
• Cross-Sectional Studies
• Female
• Humans
• India/epidemiology
• Male
• Morbidity
• Refraction, Ocular
• Refractive Errors/diagnosis
• Refractive Errors/epidemiology
• Schools
• Students
• Vision Screening/methods