Comparison of computer-photoscreening with non-cycloplegic retinoscopy for amblyopiogenic risk factors in children

Objective To determine the sensitivity and specificity of using a computer-photoscreene r and non-cycloplegic retinoscopy in the detection of amblyopiogenic factors in nine to fifty months old infants and children. Methods Three hundred children, nine to fifty months old, were screened with the compute r-photoscreener and non-cycloplegic retinoscopy.With a blinded standardized clinical assessment as the standard, an overall comparison of the sensitivity of and specificity results obtained with the two techniques was made.Photoscree n images on the computer monitor screen were reviewed and analyzed immediately by two independent observers for indicators of amblyopiogenic risk factors.Simu ltaneously, the results were compared to the findings of a full ophthalmologic examination. Results The computer-photoscreener revealed a sensitivity of 94.6% and specificity of 90.1%, and the non-cycloplegic retinocopy revealed a sensitivity of 85.7% and specificity of 81.0% for the detection of amblyopiogenic risk factors, includi ng hyperopia (+2.75 D or more), myopia (-1.50 D or more), astigmatism (1. 75 D or more), anisometropia (2.00 D or more), ocular misalignment (5 degrees o r more), and media opacity (1.5 mm or more). Conclusions The computer-photoscreener offers an opportunity to identify problems that limi t vision, and could provide a feasible and sufficiently reliable screening techn ique in infants and preschool children to be screened successfully for amblyopio genic risk factors.