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Can the bruckner test be used as a rapid screening test to detect amblyogenic factors in developing countries?
Purpose:
To determine the usefulness of the Brückner test as a screening tool for detection of amblyogenic factors in developing countries.
Methods:
A double blind prospective study of 101 children aged 1 to 16 years attending the pediatric ophthalmology department of a tertiary eye care center. A trained optometrist masked to clinical findings of the subject performed the Brückner test in a dark room using a direct ophthalmoscope and compared differences in brightness of the pupillary reflex of both eyes. Subsequently, subjects underwent a complete ophthalmic examination by a pediatric ophthalmologist masked to the results of the Brückner test.
Results:
The optometrist identified 39 subjects as Brückner test positive and 62 as Brückner test negative. On clinical examination, 12 subjects had anisometropia of ≥1D and 20 subjects had manifest deviation of >4(Δ). The sensitivity of the Brückner test was 87.5% and specificity 84.1%; the positive (PPV) and negative predictive (NPV) value was 71.8% and 93.6%. The false positive and false negative rates were 28.2% and 6.5%.
Conclusion:
Although imperfect, the Brückner test may be a low cost alternative to either screening with photo screener or to no screening for amblyogenic factors in developing countries.
