EyeSpy 20/20™: Transforming Eye Screens

Manual Vision Screenings	VisionQuest 20/20’s EyeSpy 20/20™
Routine Testing Typically Uses: Wall Chart Developed in 1862 (distance acuity) And Sometimes, But Not Necessarily, Uses: Stereogram (depth perception)	EyeSpy 20/20™ System Features: Video matching game format (distance acuity)   Computerized Stereogram (depth perception)
Challenges & Limitations Differences in eye performance are difficult to detect   Kids feel pressured to “pass a test” so they may memorize the chart or peek during test   Proctors must receive considerable training to ensure appropriate administration and accuracy   Administration is not standardized and results are subject to human interpretation   Manual, labor-intensive data management and reporting   Difficult to administer to many special needs populations	Opportunities & Solutions A single system that screens distance acuity and depth perception, testing for all of the most prevalent and severe vision disorders.   Randomization of optotypes eliminates memorization   Minimal training required and limited proctor involvement, without compromising accuracy   Independent scientific validation by Medical University of South Carolina’s world-renowned Storm Eye Institute   Computerization of data collection and reporting saves significant staff administration time   Can be used successfully with many special needs populations that often cannot be tested successfully with traditional methods

The Science Behind the Technology

Unlike the old-fashioned Eye Chart, which was established in 1862 and requires a highly trained professional to properly administer the test, EyeSpy 20/20™ does not require in-depth training to administer. Developed by VisionQuest 20/20, EyeSpy 20/20™ promotes vision screening techniques and methods consistent with national experts in children’s vision such as the US Department of Health and Human Services, the American Academy of Ophthalmology, the American Academy of Pediatric Ophthalmology, the American Academy of Pediatrics, and The National Association of School Nurses among others.

Our innovative software game, EyeSpy 20/20™, automates the traditional eye chart and adds depth perception assessments, which continue to be the standard for checking for vision problems in children 5 years old and older. The automation provides consistent results without the expense of engaging certified professionals for an initial vision screening.

Testing visual acuity one eye at a time in combination with depth perception testing (stereopsis) to confirm the eyes are working together, allows all the important childhood vision disorders to be efficiently and effectively screened and excluded. These include amblyopia (lazy eye), strabismus (eye misalignment), cataracts, and focusing problems (nearsightedness, extreme farsightedness, and astigmatism). It does all this while making the screening fun for children and a joy to administer... a significant improvement from the 150 year old wall chart.

Intelligent Software

EyeSpy 20/20™’s scientifically validated logic determines:

• Which eye chart is most ideal based on age and expert recommendations
  
  
• An automated pretest makes certain the child “understands” the game. Randomization of the symbols used in testing prevents memorization
  
  
• Simple instructions “pop up” on the computer (such as, guiding the proctor to patch a particular eye or use colored lenses during testing
  
  
• The size and order of symbol presentation is determined in “real time” based on the child’s actual responses
  
  
• Answer response times are measured and compared to evaluate whether a child is struggling more with one eye or the other
  
  
• An automated “retest” is built in the logic protocol when needed to make certain the results are valid
  
  
• The game format engages children, which enhances their attention and the reliability of testing
  
  
• Pass/fail decisions are determined based on age related criteria programmed into the software
  
  
• Language Choice. Vision Screening results are printed (in English or Spanish) to facilitate communication with parents

Over 160,000 school children have been accurately screened with great acceptance by schools, parents, and the students themselves. Unlike traditional vision screenings, which require a trained and experienced proctor for reliable results (who are often in short supply), the EyeSpy 20/20™ software provides reliable and consistent results regardless of who administers the test. A parent or other volunteer with no prior training can accurately screen children’s vision in just minutes. Not only does this mean less expensive testing for all children, but late transfers or children who miss school on screening day can be tested at anytime throughout the school year as the software is always available, even if an experienced proctor is not.

For children with special needs or those who are too young to reliably have their visual acuity assessed, the EyeSpy 20/20™ software also integrates with other accepted vision screening technologies such as Welch Allyn Suresight, and the Plusoptix and Pediavision autorefractors. Additional validated technologies will continue to be integrated into the program over time to make certain schools will to continue to have the ability to choose from a menu of the best and latest vision screening technologies.

Simplify Data Management

EyeSpy 20/20™ vision screening software has another benefit, computerization of data management.

School and health experts consider monitoring and communicating results of school vision screening programs an essential part of a well-designed public health model. Good communication between school health personnel and parents is important in the best of circumstances, but becomes even more critical when there are financial, logistical, educational or other barriers to overcome. EyeSpy 20/20™ helps promote efficiency by streamlining the data gathering and reporting process.

A successful program needs to have an efficient way to monitor which students have been screened, who has passed and who needs either rescreening or a referral to an eye professional. And when a complete eye examination is recommended, the program needs the ability to notify and coordinate with the parents to make certain the student receives the needed services. Since vision screenings are performed on a computer, student rosters can be easily downloaded to the software to prevent tedious typing of student’s names. The screening results are incorporated automatically into the software program as the vision screenings are performed. Results can be printed immediately or saved to distribute to parents later.

Screenings can be performed on multiple computers simultaneously with no Internet connection required during the actual screenings. Once an Internet connection is established, screening results from multiple computers used in a particular school, district, or state are consolidated into a password protected, HIPAA-compliant, “cloud based” data repository which can be accessed only by authorized school representatives. The student roster and data management portion of EyeSpy 20/20™ allows screening results to happily coexist regardless of what particular integrated technology, or combination of technologies, a school chooses to employ. Schools may elect to use technologies they currently own then upgrade over time as technology improves and funds permit.

The Methodology of Developing EyeSpy 20/20™

As an advocate for eliminating preventable childhood blindness and other vision disorders, VisionQuest 20/20 is actively seeking change in the technology, availability and implementation of vision screenings in America. Based on this mission, VisionQuest 20/20 developed EyeSpy 20/20™ based on 8 simple yet critical steps to offer quality, consistent and accurate vision screenings to school age children across America.

Step 1: Method - Technique or product used to perform screening
The method used must evaluate the performance of how the entire vision system works together including the eye, optic nerve, and vision center of the brain.

Step 2: Validation - Scientific validation of method from real-world, clinical studies
Regardless of the methodology chosen for screening vision disorders, it must be accurate and reliable in both the controlled setting of a laboratory as well as real-world situations such as a classroom environment.

Step 3: Distribution - Bringing the method to all our nation's children
Once a validated method for screening children's vision has been chosen, there must be an efficient way to distribute this method and make it widely available to all our nation's school children.

Step 4: Administration - Performing the method on all our nation's children
The screening must be administrated in a consistent and accurate manner regardless of when or where it is performed.

Step 5: Results - Analyze raw data and compare to standardized criteria
After the screening has been performed, the results need to be analyzed and compared to standardized pass and fail criteria to determine if further evaluation is required.

Step 6: Data Storage –
Store and retrieve data for record keeping, dissemination to parents, caregivers, medical professionals and future comparisons and further analysis.

Screening outcomes and result interpretation are stored for two different reasons. First, immediate record keeping is necessary to ensure all children are screened and that there is no redundant vision screenings performed. Secondly, data storage allows for comparisons with other schools and epidemiological analysis, while remaining secure and HIPPA compliant.

Step 7: Notification –
Inform Parents, teachers and doctors of results and initiate referral if necessary.

Step 8: EPI Analysis –
Measures success of vision screening program and provides valuable scientific data for public health policy decisions.

Epidemiological data analysis allows the success of the vision screening program to be measured and provides valuable scientific data for public health policy decisions. Such data is crucial to provide information for continued public and private support and funding.