Vision screening with the RDE stereotest in pediatric populations

The usefulness of the Random Dot E (RDE) stereotest in screening the vision of school-aged children for vision problems has been established. As a single screening procedure, the effectivity (phi) of the RDE (phi = +0.52) is greater than the widely used Snellen acuity technique (phi = +0.36) and faster to complete. Very-low-birthweight (VLBW) children have a higher incidence of vision problems including strabismus, amblyopia, and refractive error than children born with normal-birthweights (NBW's). My purpose was to determine: (1) whether a group of young children at high risk for vision problems could perform random dot stereotesting and (2) an age appropriate pass/fail criterion for stereoacuity screening. Furthermore, categorization as pass or fail by each screening method studied [stereoacuity (RDE), visual acuity [Teller Acuity Cards (TAC) and Broken Wheel (BWA)] and refractive error] was compared for independent agreement with vision examination results. The subjects were a cohort of NBW and VLBW) (< 1500 g) children matched at birth for maternal age, ethnic origin, time of hospital birth, and parity. Results of a masked investigation of 30 children [VLBW (N = 10) and NBW (N = 20) children] tested at 3 years of age (mean age = 3.0 years, range 2.11 to 3.1 years) showed that (1) 86.7% were able to complete the 168 sec arc random dot stereoacuity task when a two-alternative forced-choice preferential-looking paradigm was used for testing, (2) the specificity and sensitivity were 88.2%, 76.9% (RDE); 81.2%, 64.3% (TAC); 52.9%, 92.3% (BWA); and 94.1%, 61.5% (refractive error), respectively, (3) the reliability the RDE stereoacuity screening was greater (k = +0.66) than any of the other procedures studied, and (4) there was 73.3% agreement on test-retest categorizations between observers.(ABSTRACT TRUNCATED AT 250 WORDS)