[Photoscreening for early detection of amblyogenic eye changes]

Congenital and early acquired ocular changes impairing the optic input induce amblyopia when left untreated. Amblyopia treatment must start early to be efficient. Therefore it seems necessary to employ screening tests in preverbal childhood.

The reliability of two commercially available photoscreening devices, the "Visiscreen 100" (Vision Research Corp.) and the "MTI-Photoscreener" (Medical Technology Inc.), was tested. 180 children from a kinder-garten and 120 infants from our outpatient clinic were screened. The results were compared to the findings of a full ophthalmologic and orthoptic examination.

The efficacy of the photoscreening depended on the skill of the examiner and on the age of the children tested. The rate of interpretable photographs was 94% in the older group and 63.3% in the infants. The mean sensitivity for detection of amblyogenic factors was 63% in the older and 80% in the infant group. The mean negative predictive value was 90%, and 75%, respectively.

Modern photoscreening techniques can help to detect amblyogenic factors in early childhood. However, in addition to the non-interpretable photographs, about 20% of the affected children are missed. Therefore, photoscreening cannot be recommended for countries with a high number of ophthalmologists, such as Germany. Instead, an ophthalmologic and orthoptic investigation in early childhood would be preferable.