A pilot study evaluating the use of EyeSpy video game software to perform vision screening in school-aged children

Purpose To compare the vision-screening results of school-aged children tested with EyeSpy software and those of children examined by a pediatric ophthalmologist. We also compared combined results of an electronic visual acuity (EVA) tester and stereopsis testing to the results of a professional eye examination. Methods In this pilot study, all children were tested with an EyeSpy and ETDRS EVA tester, followed by ocular examination including stereopsis assessment and cyclopegic refraction. The order of presentation of the EVA and EyeSpy assessments was assigned randomly. The EyeSpy test was performed twice (with an occlusive eyepatch and red-blue dissociative goggles). EyeSpy registered pass or refer results for visual acuity testing at a threshold of 20/32 visual acuity and stereopsis of 300 arcsec. Similar threshold values were used in the EVA/stereopsis testing. Results The average age of 72 subjects was 11.4 ± 2.2 years. Prevalence of visual impairment was 25 (34.7%) of 72 as reported by the professional examination. The sensitivity, specificity, and conventional positive likelihood ratio were 88%, 87%, and 6.8 when EyeSpy was used with a patch; 88%, 74%, and 3.44 when EyeSpy was used with goggles; and 88%, 94%, and 13.79 for EVA/stereospsis, respectively, compared with the gold-standard professional eye examination. EyeSpy screening results using a patch were not significantly different than those of a professional examination ( p = 0.508). The 2 results concurred in 63 (87.5%) of 72 subjects. Conclusions EyeSpy software has potential for use as a vision-screening device. The use of EyeSpy with an occlusive patch outperformed EyeSpy with dissociative glasses.