Performance of the 2WIN Photoscreener With "CR" Strabismus Estimation in High-Risk Patients

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American Journal of Ophthalmology


Purpose: Accurate estimation of refractive error and ocular alignment is critical for identifying amblyopia risk factors. The 2WIN photoscreener (Adaptica) uses a novel infrared-transmitting occluder wand to quickly estimate intermittent deviations.

Design: Reliability analysis.

Methods: 2WIN refraction was compared to dry and cycloplegic retinoscopy and Retinomax. 2WIN "CR" function with wand was compared to cover test.

Results: 371 patients aged 6 months to 63 years (median age 6 years) had refraction, and 2WIN yielded high degrees of correlation (Pearson product-moment) on linear regression for spherical equivalent (0.73-0.79), cylinder power (0.78-0.79), J0 vector (0.79-0.83), and J45 vector (0.64-0.67). Similar proportions of 2WIN and Retinomax were within target refraction values for spherical equivalent (70% [216/310] vs 69% [212/310]), cylinder power (94% [154/165] vs 90% [148/165]), and cylinder axis (69% [113/165] vs 71% [118/165]). 2WIN CR higher than 10 prism diopters (PD) correlated with cover test for constant and intermittent deviations (Pearson correlation 0.64-0.71). 2WIN + CR screened for 2003 American Association for Pediatric Ophthalmology and Strabismus amblyopia risk factors with 68% (965/96) sensitivity and 84% (70/83) specificity in preschool children with 53% (96/180) prescreening probability and 31% (55/177) developmental delays.

Conclusion: The 2WIN correlated well with examination and Retinomax. The CR function reliably estimated constant and intermittent strabismus higher than 10 PD.



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