Effectiveness of the Welch Allyn SureSight Autorefractor as a Screening Tool in a Sample of Children Aged 3-69 Months

This study compares the Welch Allyn SureSight Autorefractor readings with conventional refractive findings of 93 children, whose ages ranged from 3 to 69 months. The Autorefractor’s findings and the associated reliability number were recorded. If the findings had a low reliability (< 5), another measurement was attempted. At the conclusion, a pass/fail decision for each child was independently made using age dependent refractive criteria. The children who passed/failed the autorefraction screening were then compared to the children who passed/failed the refract ive component of the optometric examination. The sample was divided into two subgroups; children age 3 months to 36 months and children 37 to 69 months. The analytical measures for the younger group were sensitivity 62.5% and specificity of 83.3%. False positives were 28.6%, while false negatives were 23.0%. In the older subgroup, sensitivity was 87.5% and specificity was 65.3%. False positives were 44.7% while false negatives were 8.6%. The high sensitivity and low false negative analytical measurement in our older age group indicate that using the SureSight Autorefractor as a screening tool for refractive conditions is more effective in the older age group. However, this is offset some by the lower specificity and high percentage of false positives found in the older group, which could result in excessive referrals. In the younger subgroup there was less evidence as to the effectiveness of the SureSight autorefractor as a viable refractive screening instrument when compared with a more standard visual evaluation.