Document Detail

The Brückner test: extended distance improves sensitivity for ametropia.
MedLine Citation:
PMID:  17602235     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Brückner test is usually performed at a distance of 1 m. Due to optical reasons, the test should detect ametropia more sensitively at an extended distance. We compared the sensitivity of the test to detect unilateral ametropia at a distance of 4 m versus the traditional distance of 1 m. PATIENTS AND METHODS: In this study, five blinded experienced observers (experts) performed the Brückner transillumination test on five emmetropic subjects (age 22.3 +/- 2.3 years) at a distance of 1 m which was then extended up to 4 m. Unilateral ametropia was simulated by both spherical and cylindrical lenses of -1, -2, -3, -4, and +1, +2, +3, +4 diopters in front of one eye and a plano lens in front of the other eye in a randomised order. Controls with plano lenses in front of both eyes were interspersed. The test was considered positive in case of any difference between the red reflexes of both eyes. For spherical ametropia, the procedure was repeated with 25 medical students who examined one subject each. RESULTS: At a distance of 1 m, unilateral myopia/hypermetropia of more than 1 diopter was detected in 78.7%/71.3% by experts and in 34.7%/53.3% by students. At 4 m, detection rates increased to 99.3%/96.0% and 98.7%/100% respectively. Rates of false positive findings for experts vs students were 3.1% vs 1.5% at 1 m and 4.0% vs 3.0% at 4 m. For unilateral astigmatism, experts' detection rates were similar at 1 m (64.7%/70.0%) and lower at 4 m (91.7%/90.3%), depending on the astigmatism axis. CONCLUSIONS: The sensitivity of the Brückner reflex for anisometropia improves by extension of the examination distance, especially in the hands of less experienced observers. To detect ametropia more sensitively, a test distance of 4 m is recommended.
Michael Gräf; Annette Jung
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-06-30
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie     Volume:  246     ISSN:  1435-702X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-11-20     Completed Date:  2009-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  135-41     Citation Subset:  IM    
Department of Ophthalmology, University of Giessen, Friedrichstr. 18, 35385, Giessen, Germany.
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MeSH Terms
False Positive Reactions
Pilot Projects
Predictive Value of Tests
Refractive Errors / diagnosis*
Reproducibility of Results
Sensitivity and Specificity
Single-Blind Method
Vision Screening / instrumentation*

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

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