The purpose of this study was to compare the effectiveness of the plus lens test versus the Spot vision screener. This was a prospective study and 109 children aged two to 12 years (62% female) underwent both assessments followed by a comprehensive paediatric ophthalmic examination. Mean age was 82.1 months. In comparison to the ophthalmic examination, sensitivity and specificity of the plus lens test was 43.75% and 89.25% for +3.5D hyperopia and 41.67% and 87.63% for +4D hyperopia. For the Spot vision screener, sensitivity and specificity for +3.5D hyperopia was 31.25% and 100%; for +4D hyperopia, it was 33.33% and 98.97%. The plus lens test was slightly more sensitive than the Spot vision screener and there were issues with detecting high hyperopia overall. The authors recommend that children with difficulty with near tasks should receive a comprehensive exam including cycloplegic refraction. 

Detecting high hyperopia: The plus lens test and the Spot vision screener.
Feldman S, Peterseim MW, Trivedi RH, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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