J AAPOS. 2026 Jul 28:104911. doi: 10.1016/j.jaapos.2026.104911. Online ahead of print.

ABSTRACT

PURPOSE: To report the prevalence of refractive error, amblyopia, strabismus, and other ocular pathology in children participating in a vision screening program in American Samoa, a population under-represented in the ophthalmologic literature.

METHODS: We performed a retrospective chart review of school-based vision screenings using a PlusOptix S12 photoscreener in children 3-18 years of age in American Samoa over a period of 13 months. All children who failed the vision screening received a cycloplegic eye examination by a pediatric ophthalmologist, who prescribed glasses and referred children to local eyecare providers for follow-up.

RESULTS: The program screened 743 children (mean age, 7.6 ± 2.8 years). Of these, 122 children failed the vision screening. Upon receiving eye examinations, 44 (36%) of them had refractive error (42 with astigmatism, 4 with myopia, and 2 with hyperopia), 3 (2%) had strabismus, and 8 (7%) had other ocular pathology. Seventy-seven children (63%) met the threshold for spectacle correction. The positive predictive value of the PlusOptix device was 42% (95% CI, 33%-51%) for detecting amblyogenic risk factors (ARFs) and 82% (95% CI, 75%-89%) for identifying patients needing follow-up care.

CONCLUSIONS: In American Samoa, the PlusOptix photoscreener performed similarly to other vision screening programs in the detection of ARFs. The participants in this program had a high rate of astigmatism and need for prescription glasses; however, the rate of strabismus and ocular pathology was lower than expected compared to other vision screening programs.

PMID:42520922 | DOI:10.1016/j.jaapos.2026.104911