Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Theresa A. Kessler


Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this evidence-based practice project was to determine if screening a pediatric population ages 9 months, 24 months, 36 months, and 48 months using an automated visual screener would affect the number of refractive errors detected. The Stetler Model’s stepwise process for gathering sound evidence was used to guide this evidence-based practice project at a busy Midwest pediatric clinic. Anyone that failed the screening was referred to ophthalmology for further testing. Post-intervention group data were collected on patients from the designated age groups receiving visual screening during a well-child check-up by two designated providers over a three-month period. Pre-intervention group data were collected from electronic health records for patients in the same designated age group receiving a well-child check-up by the same two providers as post-intervention data over a three-month period. Data were analyzed using Pearson’s Chi-Square Goodness of Fit test in an effort to show the sensitivity and specificity of the automated visual screener to screen for amblyopic risk factors. Of the total sample size (N = 322), there were 161 in the pre-implementation group and 161 in the post-implementation group. Results supported the PlusOptix™ S12 vision screener in identifying more refractive errors than traditional visual exams performed during routine well child check-ups (χ2 = 20.184a, p < 0.001, 99% CI).