Early Childhood Photoscreening Supports Better Eye Care in Rural Alaska – By Arwen Botz

Photoscreening is an efficient and effective method of identifying kids at risk for amblyopia.

The Kodiak Area Native Association (KANA) serves a 12,000-member community located on a large, mostly uninhabited island in Alaska. I am a Developmental Specialist with the KANA Infant Learning Program. This is a part of the Alaska Early Intervention system that works with young children, who are experiencing developmental delays, or are at risk of developing such delays, and their families.

KANA collaborates with Alaska Blind Child Discovery (ABCD), a cooperative, charitable research project to conduct vision screening on every preschooler in Alaska. ABCD is the brain child of pediatric ophthalmologist Robert Arnold, MD. During his pediatric fellowship at Indiana University, Dr. Arnold became intrigued with detecting small-angle strabismus using the Brückner Test. After starting practice in Anchorage with Ophthalmic Associates in 1989, he began publishing clinical research around modifying the test. As his interest in photoscreening advanced, Dr. Arnold began working with public health nurses, and later various charities to launch screening clinics in urban and remote villages.

Plusoptix Blog - Early Childhood Photoscreening Supports Better Eye Care in Rural Alaska - Bob Arnold
Pediatric ophthalmologist Robert Arnold, MD

Originally, after photoscreening was conducted at the KANA-run vision clinics, Dr. Arnold had to review all the printouts to determine which kids needed a follow-up exam. For 15 years, this was a tedious and time-consuming process, with often poor picture quality complicating the situation. Then 3 years ago, KANA acquired grant funding to purchase a Plusoptix vision screener.

Dr. Arnold recommended the device based on his years of research and in studying the evidence. The American Academy of Pediatrics guidelines for pediatric vision screening recommend photoscreening for the early detection of conditions that lead to treatable blindness due to amblyopia. In Alaska’s statewide experience, objective screening with the Plusoptix Vision Screener works very well in community screening from age 1 to age 7 years and has been shown to take only 20 about 30 seconds per child. For instant refractive and strabismus estimates, the Plusoptix S12 is user-friendly and has the most validation research experience.

Now, our program’s staff uses the Plusoptix device to screen preschoolers during two yearly outreach events. We also hold a monthly open-door program where anyone can come in for a Screening. And we also evaluate all children, birth to 3 years, who have been referred to our program due to the risk of developmental delay. Additionally, we fly to each of the villages on the island to conduct vision screenings for any children there as well. Dr. Arnold has often said, that our outreach has made Kodiak the most screened community in Alaska.



KANA has been very successful with our screening programs and in getting kids the necessary visual support afterward. The Plusoptix device has played a pivotal role in streamlining our process, making screening more effective and efficient. It is crucial that we have a screener that is portable and easy to use. The staff was quickly trained on how to capture kids’ readings with photoscreening.

After receiving amazing technical support and helpful tips from the company’s representatives, we have been able to screen our groups more accurately and speedily. Our rate of referral is about one in six. We know that these kids are getting the treatment they need sooner and are having more success in school than they would have without treatment. When a child is referred for follow-up, he or she is seen locally by an optometrist and will have an evaluation by Dr. Arnold when he flies to the island twice yearly. Or may fly up to see to Dr. Arnold in Anchorage, if necessary.


Have you already read the previous blogposts about preventive eye care in children? Have a look at them on the blog’s starting page.

Best regards

Your Plusoptix team

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