フセヤ　ケイコ   Fuseya Keiko   伏屋　恵子    所属   東邦大学  医学部 医学科（大森病院）    職種   院内助教
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Esotropia Missed During Pre-health Checkup Screening With the Spot Vision Screener: A Case Series
掲載誌名	正式名：Cureus ISSNコード：2168-8184
掲載区分	国外
著者・共著者	Keiko Fuseya, Tadashi Matsumoto, Momoko Kawakami, Erika Chiba, Masahiko Tomita, Yoko Kunugi, Saiko Matsumura, Yuichi Hori
担当区分	筆頭著者
発行年月	2026/03/03
概要	The Spot Vision Screener (SVS) is increasingly used for the early detection of amblyopia risk factors in preschool children, particularly during health checkups for three-year-olds. Although SVS demonstrates high sensitivity and specificity for refractive errors and amblyopia risk factors, its ability to detect strabismus, especially accommodative esotropia, remains limited. We present a case of accommodative esotropia in children under three years of age where SVS failed to detect ocular misalignment. In all cases, SVS indicated only mild hyperopia and did not detect strabismus; however, subsequent ophthalmological assessment revealed accommodative esotropia, which was confirmed by cycloplegic refraction. All patients responded well to full hyperopic correction with spectacles, which resulted in improved or normalized ocular alignment. These cases highlight the potential for false-negative strabismus results with SVS, particularly in young children and in cases where esotropia is variable or predominantly manifests at near. Our findings underscore the need for a comprehensive clinical assessment, including careful observation, cycloplegic refraction, and repeated SVS measurements, to ensure timely and accurate referral for ophthalmological evaluation. Enhanced education and training for healthcare professionals involved in vision screening are also essential to maximize the detection rates of amblyopia and strabismus and to prevent missed diagnoses of clinically significant strabismus.
DOI	10.7759/cureus.