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Ultra-rapid school vision screening in developing nations using the Brückner test
Mihir Kothari1, Snehal Kosumbkar
1Jyotirmay Eye Clinic, 205, Ganatra Estate, Pokhran Road No. 1, Khopat, Thane West 400601, Maharashtra, India. drmihirkothari@jyotirmay.com
Insights
The Brückner test offers rapid vision screening for school children, proving highly effective with excellent specificity and negative predictive value. This method is suitable for developing nations, requiring minimal time per child.
Area of Science:
- Ophthalmology
- Public Health
- Pediatric Vision Screening
Background:
- Vision impairment is a significant public health concern in school-aged populations.
- Early detection of vision problems is crucial for academic success and overall development.
Purpose of the Study:
- To evaluate the Brückner test as a screening tool for school children.
- To compare its efficacy against conventional vision testing methods.
Main Methods:
- A pediatric ophthalmologist administered the Brückner test, followed by masked conventional vision testing by an optometrist.
- The Brückner test was conducted with both room lights on and off to assess optimal conditions.
Main Results:
- The Brückner test demonstrated high sensitivity (88%) and specificity (98%) for detecting vision impairment (< 6/9).
- It achieved a negative predictive value of 99%, indicating high reliability in identifying children without vision issues.
- The test required less than 10 seconds per child, highlighting its efficiency.
Conclusions:
- The Brückner test is a viable ultra-rapid screening method for school children, particularly in developing countries.
- Further research is recommended for its application in preverbal, mentally impaired, or uncooperative children.
- Comparative studies with cycloplegic refraction are needed to validate findings.
Purpose:
To compare the Brückner test with conventional vision testing for the screening of school children.
Subjects And Method:
A pediatric ophthalmologist performed the Brückner test followed by a vision testing by a masked optometrist. The test was performed initially in a closed room with the room-lights on for the first 1714 children and with the room lights off for the remaining 657 children.
Results:
Prevalence of presenting vision < 6/9 in the urban school was 9.11%. Sensitivity of the Brückner test was 88%, specificity was 98%, predictive value of the positive test was 69%, and predictive value of the negative test was 99%. The specificity and predictive value of the positive test were slightly better with the room lights off. The time required to perform the Brückner test was less than 10 seconds per child.
Conclusion:
The Brückner test can be used for ultra-rapid screening of school going children in developing nations. Further studies are required to explore its use for vision screening of preverbal children, mentally retarded children and uncooperative children. Follow-up studies are required to compare the results of the Brückner test with cycloplegic refraction.
