# Community-based amblyopia screening using a novel device

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $258,135

## Abstract

PROJECT SUMMARY
Worldwide, more than 500,000 children become blind each year, and the majority of blind children live in low-
and middle-income countries (LMICs), where rates of preventable vision loss and blindness are significantly
higher. Amblyopia is the leading cause of vision loss in children worldwide. Vision loss from amblyopia can be
prevented through early, effective amblyopia screening, though current screening devices have high sensitivity
and low specificity which leads to a high number of false positive referrals. This ultimately limits the success of
amblyopia screening programs due to increased cost and resource utilization, which is of particular concern in
LMICs and low resource settings. This proposal will evaluate the efficacy and cost-effectiveness of two
amblyopia screening devices and screening strategies: a current standard device, autorefractor (AR), which
only detects amblyopia risk factors, and a novel device, retinal birefringence scanner (RBS), which detects
amblyopia directly. Aim 1 of this proposal will compare the performance of the AR and RBS devices for
detecting amblyopia in a clinic-based setting in Nepal. Aim 2 will compare the devices in a community-based
setting in Nepal. Aim 3 will compare the cost-effectiveness of these two amblyopia screening strategies and
devices. The feasibility of these Aims is anchored by collaboration with the Village Integrated Eye Worker II
(VIEW II) trial, a cluster-randomized trial led by the candidate’s primary mentor, Dr. Jeremy Keenan. The VIEW
II trial randomizes adults in peri-urban communities in Nepal to undergo a vision screening intervention by
trained community outreach workers. This proposal incorporates several innovations. First, it uniquely
leverages a well-established adult vision screening infrastructure to create and evaluate a screening program
for children. Second, it will be the first study to directly compare the performance and cost of two amblyopia
screening strategies. The candidate, Dr. Julius Oatts is a pediatric ophthalmologist at the University of
California, San Francisco (UCSF), whose long-term goal is to become an independent investigator with
expertise in diagnostic accuracy studies for novel technologies to diagnose and monitor preventable vision loss
in children nationally and internationally. To successfully complete this research, Dr. Oatts will focus on four
relevant domains of training: diagnostic accuracy studies, clinical trial design, cost-effectiveness analysis, and
epidemiology and biostatistics. His exceptional mentorship team includes his primary mentor, Dr. Jeremy
Keenan, Director of International Programs at the Proctor Foundation and PI of the VIEW II trial, and co-
mentors Dr. David Hunter, Chief of Ophthalmology at Boston Children’s Hospital, and Dr. Ying Han, Director of
the UCSF Glaucoma service. This team, combined with the environment of the Proctor Foundation and UCSF
Department of Ophthalmology, will support his development...

## Key facts

- **NIH application ID:** 10865036
- **Project number:** 5K23EY034893-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Julius Oatts
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $258,135
- **Award type:** 5
- **Project period:** 2023-07-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10865036

## Citation

> US National Institutes of Health, RePORTER application 10865036, Community-based amblyopia screening using a novel device (5K23EY034893-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10865036. Licensed CC0.

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