Digital Infrared Reflex Testing and Asynchronous Teleconsultation for Infant Eye Screening

Digital Infrared Reflex Testing and Asynchronous Teleconsultation for Infant Eye Screening | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Digital Infrared Reflex Testing and Asynchronous Teleconsultation for Infant Eye Screening Elisabetta Racano, Chiara Spinelli, Giuseppina Sacco, Giorgia Bendetti, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8871642/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Feb, 2026 Read the published version in Scientific Reports → Version 1 posted You are reading this latest preprint version Abstract Background Early detection and documentation of anterior segment opacities in infants (aged 1–6 months) is limited by resource constraints and specialist availability. This study aimed to evaluate the usefulness of digital infrared reflex testing (IRRT) and to estimate the feasibility of asynchronous teleconsultation between primary care paediatricians and ophthalmologists for infant eye screening. Methods From April 2024 to March 2025, 189 infants aged 1–6 months underwent both digital IRRT and standard red reflex testing (RRT) in primary care settings. Digital images and clinical data were evaluated using teleconsultation between paediatricians and ophthalmologists. The feasibility endpoints included the proportion of successful teleconsultations, user acceptability, and technical barriers. IRRT versus RRT diagnostic agreement and the IRRT inconclusive examination rate were also assessed. Results Teleconsultation was feasible in 84% of the cases. The principal barriers were operational issues (time and setting) and staff training needs. Digital IRRT had an inconclusive result rate of 5.3% and high agreement with RRT (AC1 = 0.994, 95% CI: 0.983–1.000). Conclusion Digital IRRT combined with teleconsultation is a feasible and accurate approach for infant eye screening in primary care settings, supporting image documentation, integration into telemedicine workflows, and potential future AI applications. Ophthalmology Pediatrics Digital infrared reflex testing (IRRT) 2Win videoscreener infant eye screening asynchronous teleconsultation Full Text Additional Declarations The authors declare no competing interests. Supplementary Files IRRTvideo2Win.mov Cite Share Download PDF Status: Published Journal Publication published 20 Feb, 2026 Read the published version in Scientific Reports → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8871642","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":590873820,"identity":"a7e440c6-841a-4d59-94a7-de30aff8c8fe","order_by":0,"name":"Elisabetta 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Screening\u003c/strong\u003e\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"Azienda Sanitaria per i Servizi Sanitari di Trento","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Digital infrared reflex testing (IRRT), 2Win videoscreener, infant eye screening, asynchronous teleconsultation","lastPublishedDoi":"10.21203/rs.3.rs-8871642/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8871642/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEarly detection and documentation of anterior segment opacities in infants (aged 1\u0026ndash;6 months) is limited by resource constraints and specialist availability. This study aimed to evaluate the usefulness of digital infrared reflex testing (IRRT) and to estimate the feasibility of asynchronous teleconsultation between primary care paediatricians and ophthalmologists for infant eye screening.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eFrom April 2024 to March 2025, 189 infants aged 1\u0026ndash;6 months underwent both digital IRRT and standard red reflex testing (RRT) in primary care settings. Digital images and clinical data were evaluated using teleconsultation between paediatricians and ophthalmologists. The feasibility endpoints included the proportion of successful teleconsultations, user acceptability, and technical barriers. IRRT versus RRT diagnostic agreement and the IRRT inconclusive examination rate were also assessed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eTeleconsultation was feasible in 84% of the cases. The principal barriers were operational issues (time and setting) and staff training needs. Digital IRRT had an inconclusive result rate of 5.3% and high agreement with RRT (AC1\u0026thinsp;=\u0026thinsp;0.994, 95% CI: 0.983\u0026ndash;1.000).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDigital IRRT combined with teleconsultation is a feasible and accurate approach for infant eye screening in primary care settings, supporting image documentation, integration into telemedicine workflows, and potential future AI applications.\u003c/p\u003e","manuscriptTitle":"Digital Infrared Reflex Testing and Asynchronous Teleconsultation for Infant Eye Screening","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-16 17:54:53","doi":"10.21203/rs.3.rs-8871642/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c1a7fecb-2656-4ea3-9048-910013748418","owner":[],"postedDate":"February 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":62881080,"name":"Ophthalmology"},{"id":62881081,"name":"Pediatrics"}],"tags":[],"updatedAt":"2026-02-25T22:24:20+00:00","versionOfRecord":{"articleIdentity":"rs-8871642","link":"https://doi.org/10.1038/s41598-026-40517-3","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2026-02-21 00:00:00","publishedOnDateReadable":"February 21st, 2026"},"versionCreatedAt":"2026-02-16 17:54:53","video":"","vorDoi":"10.1038/s41598-026-40517-3","vorDoiUrl":"https://doi.org/10.1038/s41598-026-40517-3","workflowStages":[]},"version":"v1","identity":"rs-8871642","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8871642","identity":"rs-8871642","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}