November 2008




Plus Optix for amblyopia screening

by Maxine Lipner Senior EyeWorld Contributing Editor


Device proves helpful for amblyopia detection

The Plus Optix infrared video screening takes only about 10 seconds and can be done from several meters away Source: Noelle S. Matta, C.O.

When it comes to screening for amblyopia, one new device known as Plus Optix (PediaVision, Lake Mary, Fla.,) provides accurate, fast readings that are conducive to large screening programs, according to Noelle S. Matta, C.O., orthoptist, Family Eye Group, Lancaster, Pa. Results from a study published in the June 2008 issue of the Journal of the American Association of Pediatric Ophthalmology and Strabismus showed that nearly all cases of amblyopia were detected with the device.

There are two main causes of amblyopia; the first is strabismus, where the eye turns out, and is usually spotted by family members, Ms. Matta said. “The other more common cause is having high refractive error, and that’s something that a child can have in one or both eyes,” she said. “That is usually picked up by a photo-screening device at various programs or by a pediatrician doing various tests.”

Infrared video screener

However, not all photo-screening devices are the same. One feature of the Plus Optix screener that Ms. Matta likes is that it’s an objective test that is easy to administer. “It’s an infrared video camera, so there are no flashing lights or anything to scare the child,” Ms. Matta said. “It takes multiple video recordings in a row.”

The device only requires a few glances from the child to work. “Even if the child is looking around, the few times the child may be looking at the camera it will capture those images,” she said. “Once it gets enough, it will translate them into a pass or a fail.”

Other photo-screening devices can be much less forgiving. “There are other methods to do photo-screening, but a lot of times you need trained professionals with you to interpret the photo or you have to e-mail or mail it somewhere where they can interpret it and then give you the results at a later time,” Ms. Matta said. “With the Plus Optix, the pediatrician can have this in his office and in 30 seconds know if he has to refer that child to a pediatric ophthalmologist.”

United States study

The device has been studied before internationally, but Ms. Matta and fellow investigators decided to launch their own trial to see if it met with United States standards. “We’ve seen publications on it done in other countries, especially Germany, so we thought that it would be important to test it on a population in the United States,” Ms. Matta said. “We wanted to study this to make sure that it met our standards along with those that other pediatric ophthalmologists in the country agree to.”

In the study, investigators included 109 children between the ages of six months and 16 years. Ms. Matta admits that this is a very broad range. “Traditionally, vision screening is done between ages 3 to 6,” she said. However, investigators here thought that it was important to include older children as well since many of those in the practice have pathology and can’t necessarily read eye charts. “We see a lot of children who are not verbal,” she said. “Those children who can’t read the eye chart for various reasons present new challenges.” Ms. Matta is hopeful that the Plus Optix device can also be useful in determining if there are vision problems in those older children in cases where traditional methods fail.

Using the Plus Optix screener, investigators found that they could correctly detect amblyopia in nearly all cases. “The study showed that the device was very accurate in detecting patients who have amblyogenic risk factors,” Ms. Matta said. “It only missed one child who it graded as a pass but who the ophthalmologist graded as a fail.”

It turned out that this particular child did not have any significant refractive error—just a little strabismus. “We think that the child might not have been focusing enough on the light and the device may have missed the small amount of strabismus,” Ms. Matta said. “This is something that we have discussed with the company.”

With some states moving toward mandating costly comprehensive exams for all, the hope is that the Plus Optix may prove to be a more cost effective option. “This might be an easier and more economically sound way of assessing children and their need for a comprehensive eye exam,” Ms. Matta said. “Doing a vision screening on all children and just referring those who have a problem [for a comprehensive exam] would be a lot cheaper as opposed to comprehensive eye exams for all.”

A remaining hurdle with the device may be the parents themselves and getting them on board with follow up. “The biggest challenge with this device and with any vision screening device is when you tell the parents that their child failed an eye exam, [it is difficult] convincing them to follow up and comply with treatment,” Ms. Matta said.

Editors’ note: Ms. Matta has no financial interests related to her comments.

Contact information:

Matta: 717-299-9232,

Plus Optix for amblyopia screening Plus Optix for amblyopia screening
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