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

Objective To determine the sensitivity and specificity of using a computer- photoscreener and non-cycloplegic retinoscopy in the detection of amblyopio genic factors in nine to fifty months old infants and children. Methods Three hundred children, nine to fifty months old, were screened wit h the computer-photoscreener and non-cycloplegic retinoscopy. With a blinde d standardized clinical assessment as the standard, an overall comparison o f the sensitivity of and specificity results obtained with the two techniqu es was made. Photoscreen images on the computer monitor screen were reviewe d and analyzed immediately by two independent observers for indicators of a mblyopiogenic risk factors. Simultaneously, the results were compared to th e findings of a full ophthalmologic examination. Results The computer-photoscreener revealed a sensitivity of 94.6% and spec ificity 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, including 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 misa lignment (5 degrees or more), and media opacity (1.5 mm or more). Conclusions The computer-photoscreener offers an opportunity to identify pr oblems that limit vision, and could provide a feasible and sufficiently rel iable screening technique in infants and preschool children to be screened successfully for amblyopiogenic risk factors.