Abstract
AIMS—To assess non-cycloplegic screening for amblyopia with the hand held Nikon Retinomax autorefractor in 3 year old kindergarten children. METHODS—427 three year old children were examined in kindergarten with the Retinomax without cycloplegia. A gold standard was established in all children by two orthoptic examinations in kindergarten. If there were missing, abnormal, or inconsistent findings, children were referred for ophthalmological examination. If, by the ophthalmological examination, a new case of amblyopia requiring treatment was diagnosed, the gold standard was set "positive." RESULTS—In 404 children the gold standard was obtained. 10 children (2.5%) had a "positive" gold standard of unknown and untreated amblyopia. Screening sensitivity was 0.80, specificity 0.58, accuracy 0.58, and the likelihood ratio 1.89. CONCLUSION—Non-cycloplegic refractive screening with the Retinomax led to many false positive referrals due to instrument myopia and "inconclusive" results. Hence specificity, accuracy, and the likelihood ratio were too low to conduct screening effectively.
Full Text
The Full Text of this article is available as a PDF (121.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Cordonnier M., Dramaix M. Screening for abnormal levels of hyperopia in children: a non-cycloplegic method with a hand held refractor. Br J Ophthalmol. 1998 Nov;82(11):1260–1264. doi: 10.1136/bjo.82.11.1260. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harvey E. M., Miller J. M., Dobson V., Tyszko R., Davis A. L. Measurement of refractive error in Native American preschoolers: validity and reproducibility of autorefraction. Optom Vis Sci. 2000 Mar;77(3):140–149. doi: 10.1097/00006324-200003000-00013. [DOI] [PubMed] [Google Scholar]
- Harvey E. M., Miller J. M., Wagner L. K., Dobson V. Reproducibility and accuracy of measurements with a hand held autorefractor in children. Br J Ophthalmol. 1997 Nov;81(11):941–948. doi: 10.1136/bjo.81.11.941. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jaeschke R., Guyatt G. H., Sackett D. L. Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA. 1994 Mar 2;271(9):703–707. doi: 10.1001/jama.271.9.703. [DOI] [PubMed] [Google Scholar]
- Loewen N., Barry J. C. The use of cycloplegic agents. Results of a 1999 survey of German-speaking centers for pediatric ophthalmology and strabology. Strabismus. 2000 Jun;8(2):91–99. [PubMed] [Google Scholar]
- Miller J. M., Harvey E. M., Dobson V. Visual acuity screening versus noncycloplegic autorefraction screening for astigmatism in Native American preschool children. J AAPOS. 1999 Jun;3(3):160–165. doi: 10.1016/s1091-8531(99)70062-5. [DOI] [PubMed] [Google Scholar]
- Wesemann W., Dick B. Accuracy and accommodation capability of a handheld autorefractor. J Cataract Refract Surg. 2000 Jan;26(1):62–70. doi: 10.1016/s0886-3350(99)00325-9. [DOI] [PubMed] [Google Scholar]
- Williams C., Lumb R., Harvey I., Sparrow J. M. Screening for refractive errors with the Topcon PR2000 Pediatric Refractometer. Invest Ophthalmol Vis Sci. 2000 Apr;41(5):1031–1037. [PubMed] [Google Scholar]
- el-Defrawy S., Clarke W. N., Belec F., Pham B. Evaluation of a hand-held autorefractor in children younger than 6. J Pediatr Ophthalmol Strabismus. 1998 Mar-Apr;35(2):107–109. doi: 10.3928/0191-3913-19980301-10. [DOI] [PubMed] [Google Scholar]