{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:23:36Z","timestamp":1767795816153,"version":"3.49.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T00:00:00Z","timestamp":1555459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Lord Mayor's Charitable Foundation","award":["2015000702"],"award-info":[{"award-number":["2015000702"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Screening for uncorrected hyperopia in school children is important given its association with poorer visual function and academic performance. However, standard distance visual acuity screening may not detect low to moderate hyperopia. The plus lens test is used to screen for hyperopia in many school screening protocols, but has not been well validated. The current study investigated the effectiveness of the plus lens test to identify hyperopia in school children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants included Grade 2 school children. Monocular distance visual acuity (log\n                      <jats:styled-content style=\"fixed-case\">MAR<\/jats:styled-content>\n                      letter chart) was measured unaided, and then through a\u00a0+1.50D lens, known as the plus lens test. Cycloplegic refraction was undertaken to classify moderate hyperopia (\u2265+2.00D). Sensitivity, specificity, positive predictive values (\n                      <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>\n                      ) and negative predictive values (\n                      <jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>\n                      ) were calculated for commonly used cut\u2010offs for the plus lens test: 6\/6, 6\/9 and less than two lines difference between unaided acuity and acuity through the plus lens test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample included 59 children (mean age 7.2\u00a0\u00b1\u00a00.4\u00a0years). Fourteen (24%) children were classified as having uncorrected hyperopia. The sensitivity and specificity of the +1.50 plus lens test for identifying hyperopia were 0% and 98% respectively for a 6\/6 cut\u2010off, 29% and 91% for 6\/9 cut\u2010off, and 50% and 76% for a\u00a0&lt;2 line reduction between unaided acuity and acuity through the plus lens test. Receiver Operating Curve (\n                      <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>\n                      ) analysis revealed area under curves of 0.69 based on acuity through the plus lens test, and 0.65 for a reduction in acuity through the plus lens test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The plus lens test has low sensitivity for detecting uncorrected hyperopia using traditional cut\u2010offs of 6\/9 or better. This raises questions about the role of the plus lens test in school screening batteries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.12617","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T07:12:21Z","timestamp":1555485141000},"page":"141-147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Validity of the +1.50 plus lens screening test as a predictor of uncorrected moderate hyperopia"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6473-3209","authenticated-orcid":false,"given":"Shelley","family":"Hopkins","sequence":"first","affiliation":[{"name":"School of Optometry and Vision Science Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex 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