The right training but the wrong tools for vision testing mean children in the Te Tauihu region are not necessarily getting the best vision screening service. However, the implementation of new screening technology will soon fix that.

An audit of the Nelson Marlborough Vision Screening Programme in 2019 revealed that the 2014 national vision screening protocols were outdated and no longer considered industry best practice.

Jacqui Hitchcock, a hearing and vision technician based in Marlborough, says vision screening is done to diagnose amblyopia (lazy eye), or the need for further assessment, in children.

The technicians have been using the Parr letter-matching vision test which requires a child to wear a patch over one eye, look at shapes or letters displayed four metres away and then point to the equivalent shapes on a chart.

“The test is used on four to eight year-old children and requires them to be compliant and have enough comprehension to do the screening and not remove the patch,” says Jacqui.

Up to 10 per cent of children who were referred to ophthalmology appointments based on their test results were found to not actually require treatment.
“This put pressure on an already stretched service and caused unnecessary anxiety for the children and their caregivers,” Jacqui says.

The 2019 review suggested using a Welch Allyn Spot Vision Screener, or ‘Spotty’. Spotty is a handheld, portable device designed to detect six different vision conditions. It can be used for people aged from six months old and screens both eyes at once from a 1.5 metre distance.

Get Spotty3A project to test the feasibility of using Spotty for the screening programme was run in Marlborough over two months in late 2019.

“We wanted to determine the ease of use, accuracy, time savings and comfort to a child when using Spotty compared with the methods of manual screening,” Jacqui says. “Welch Allyn lent us a Spot Vision Screener and we tested 66 children and compared the results to 57 tests using the Parr chart.”


 ‘Spotty is a handheld, portable device designed to detect six different vision conditions.’

Jacqui says the device is easy to use, with a high compliance rate from the children. Overall the results are very positive and feedback from children and parents was also very favourable.

“Screening with Spotty is very quick, there’s no need for a child to wear an eye patch and it‘s effortless to use with children who have different needs.”

The Spotty device also picks up conditions not previously detected with the Parr chart, such as astigmatism.

Jacqui says the Care Foundation has provided funding for purchasing three Spotty devices for the programme.

Health Innovation Awards logo 09 Jul 2018 small4


The Getting 'Spotty' for Vision project won the Top of the South category in the 2020 Health Innovation Awards.