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This study compared two commonly used photoscreeners in a Syrian refugee camp in Jordan to better understand what types of technology would function best in a low-resource setting. The children in this study were assessed with the PEEK acuity application and photoscreening with PlusOptix (S12C) and GoCheck Kids application (Gobiquity). Vision screening was performed by Syrian American Medical Society volunteers, supervised by an ophthalmology resident from the US. The study recruited 101 participants over a five-day period: 53 male, 43 female and five of unknown gender. Average age was 7.8 years (1-16). Ten were excluded from analysis and 91 completed assessments. Twenty-eight failed at least one component of screening: six had normal ophthalmic assessment. The most common diagnoses for others included astigmatism, hyperopia, amblyopia, and strabismus. Average astigmatism was 2.71D. Average hyperopia was 4.49D. PlusOptix provided 100% sensitivity and 85% specificity in the detection of amblyopia compared with visual acuity testing. GoCheck provided 66.66% sensitivity and 94% specificity. Overall, about 10% of children had amblyopia and there was a high rate of hyperopia. Both PlusOptix and GoCheck had positive predictive values of 77% for detection of amblyopia. The PlusOptix was easier for volunteers to learn, had a higher sensitivity in detecting amblyopia and provided useful clinical information with no delay in care. However, the PlusOptix is about 8-10 times more expensive than GoCheck. The authors recommend turning off the remote review feature of GoCheck as this can lead to time delays and lapses in care. They conclude both screeners were functioning screening tools in this population and that establishing screening programmes in refugee camps with deployment of treatment resources can reduce the burden of reversible sight loss for children.

Comparison of two photoscreeners in a population of Syrian refugee children.
Gorham JP, Behshad S, Weil NC.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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