Document Detail

Identification of infants with significant refractive error and strabismus in a population screening program using noncycloplegic videorefraction and orthoptic examination.
MedLine Citation:
PMID:  12556374     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The second Cambridge Infant Vision Screening Program examined whether screening for accommodative errors by using videorefraction without cycloplegia could effectively serve as a first stage of screening for refractive errors, measured by standard cycloplegic retinoscopy. The screening also included an orthoptic examination for detection of strabismus. METHODS: All infants born in the Cambridge (UK) Health District, over a 2-year period, were invited for screening. Of those 5142 (76%) with mean age 8.1 +/- 0.8 months (SD) attended and received noncycloplegic videorefraction and an orthoptic examination. All those with a focusing error or orthoptic problem, as well as a randomly selected sample of visually normal control subjects, were invited to follow-up a month later for cycloplegic retinoscopy, repeat noncycloplegic videorefraction and orthoptic examination. RESULTS: Of the 5142 screened, 514 had a focusing error or orthoptic problem (positives). Four hundred thirty-nine of these and 284 visually normal control subjects (negatives) attended follow-up. A refractive or orthoptic condition was confirmed in 59.0% of the positive cases, whereas infants in 96.8% of the negative cases were confirmed normal. Adjusting for the proportions of the population represented by those infants seen at follow-up, sensitivity for the screening procedure was calculated at 0.67 and specificity at 0.96. Detailed results are presented in terms of the different conditions detected at screening (far, near, and anisometropic focus and orthoptic error), distribution of greatest axes at screening, and a comparison of initial videorefraction with repeat videorefraction and cycloplegic retinoscopy. CONCLUSIONS: A noncycloplegic screening procedure, simpler to perform than cycloplegic screening, succeeded in detecting a large proportion of infants with significant ametropia, particularly those with significant hyperopia, which is considered to be a strabismogenic and amblyogenic risk factor.
Shirley Anker; Janette Atkinson; Oliver Braddick; David Ehrlich; Thomas Hartley; Marko Nardini; Jacqueline Wade
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  44     ISSN:  0146-0404     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-30     Completed Date:  2003-02-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  497-504     Citation Subset:  IM    
Visual Development Unit, Department of Psychology, University College London, London, United Kingdom.
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MeSH Terms
Accommodation, Ocular
Great Britain / epidemiology
Mass Screening
Orthoptics / methods
Refraction, Ocular*
Refractive Errors / diagnosis*,  epidemiology
Risk Factors
Sensitivity and Specificity
Strabismus / diagnosis*,  epidemiology
Vision Screening / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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