| Summary: | David G Hunter Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, 02115, USACorrespondence: David G Hunter Department of OphthalmologyBoston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USATel +1 617-355-6766Email david.hunter@childrens.harvard.edu
I write to clarify some of the conclusions made by Dr. Arnold in his study of the blinq.™ vision screener.1 The goal of vision screening is early detection of amblyopia and strabismus, which until now, due to limitations in technology, could only be achieved by detecting refractive risk factors. Unfortunately, risk factor screening results in under-detection of patients with strabismus and over referral of children who would not benefit from treatment.2 The blinq. device was not designed to detect refractive risk factors; instead, the device detects amblyopia directly by performing a binocular retinal polarization scan to identify reduced binocularity, microstrabismus, and fixation instability without regard to refractive status.3 In his study, Dr. Arnold evaluated the ability of blinq. to detect amblyopia risk factors, but the performance of blinq. and all vision screening technology should be evaluated in the context of how well it identifies patients who meet diagnostic criteria for amblyopia and strabismus.4 Out of concern that his study design might create confusion among readers, I contacted Dr. Arnold, who kindly provided his de-identified data to allow me to determine which patients had referral warranted disease, not just risk factors.
View the original paper by Arnold
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