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Can the Bruckner test be used as a rapid screening test to detect significant refractive errors in children?
1Department of Pediatric Ophthalmology and Strabismus, Bombay City Eye Institute and Research Centre, 5 Victor Villa, Babulnath Road, Mumbai, India. drmihirkothari@yahoo.com
Insights
The Brückner test effectively screens children for significant refractive errors, showing high sensitivity. This rapid screening method can improve early detection of vision problems in pediatric populations.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Screening
Background:
- Refractive errors are common in children and can impact visual development.
- Early detection and correction of refractive errors are crucial for optimal visual outcomes.
- Screening tests are essential for identifying children who require further ophthalmic examination.
Purpose of the Study:
- To evaluate the Brückner test's effectiveness as a screening tool for detecting significant refractive errors in pediatric patients.
- To determine the diagnostic accuracy of the Brückner test compared to cycloplegic refraction.
Main Methods:
- A pediatric ophthalmologist prospectively assessed pupillary crescent characteristics using the Brückner test.
- Findings were compared against results from cycloplegic refraction and comprehensive ophthalmic examinations.
- Sensitivity, specificity, and predictive values were calculated for the Brückner test.
Main Results:
- The Brückner test was successfully completed in all 96 subjects within 10 seconds.
- The test demonstrated a sensitivity of 91%, specificity of 72.8%, positive predictive value of 85.5%, and negative predictive value of 83.6%.
- False negatives were primarily associated with compound hypermetropic astigmatism and myopia.
Conclusions:
- The Brückner test is a suitable and rapid method for screening children for significant refractive errors.
- Optimizing screening programs with lower crescent measurement cutoffs and standardized tools may enhance the test's utility.
Purpose:
To assess the suitability of Brückner test as a screening test to detect significant refractive errors in children.
Materials And Methods:
A pediatric ophthalmologist prospectively observed the size and location of pupillary crescent on Brückner test as hyperopic, myopic or astigmatic. This was compared with the cycloplegic refraction. Detailed ophthalmic examination was done for all. Sensitivity, specificity, positive predictive value and negative predictive value of Brückner test were determined for the defined cutoff levels of ametropia.
Results:
Ninety-six subjects were examined. Mean age was 8.6 years (range 1 to 16 years). Brückner test could be completed for all; the time taken to complete this test was 10 seconds per subject. The ophthalmologist identified 131 eyes as ametropic, 61 as emmetropic. The Brückner test had sensitivity 91%, specificity 72.8%, positive predictive value 85.5% and negative predictive value 83.6%. Of 10 false negatives four had compound hypermetropic astigmatism and three had myopia.
Conclusions:
Brückner test can be used to rapidly screen the children for significant refractive errors. The potential benefits from such use may be maximized if programs use the test with lower crescent measurement cutoffs, a crescent measurement ruler and a distance fixation target.
