A systematic review of vision screening tests for the detection of amblyopia.
OBJECTIVE
To review the test characteristics and the quality of evidence regarding available screening tests for the detection of amblyopia in preschool-aged children to help primary care practitioners select a screening strategy.


METHODS
Systematic review of published studies.


METHODS
The MEDLINE database was searched from 1966 through January 1999 using a broad and inclusive strategy. A total of 9551 citations were identified.


METHODS
All studies that compared the results of commercially available screening tests in preschool-aged children to ophthalmologic examination.


METHODS
The setting of the study, the age of the population, the type of screening test, criteria for a positive screen, criteria for the ophthalmologic examination, test characteristics, and measures of reliability were abstracted by 2 reviewers for each selected study.


RESULTS
Four eligible articles were identified that studied the test characteristics of 3 screening tests. None of these studies were performed in a primary care setting. Each study used different criteria for failure of the ophthalmologic examination. None of the studies measured observer or test reliability.


CONCLUSIONS
Few high-quality data exist regarding the performance of preschool vision screening. Important future work should include the development of a consensus gold standard ophthalmologic examination and evaluation of screening tests in the primary care setting.
Kemper
A R
AR
Children's Primary Care Research Group, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina 27599-7225, USA. akemper@med.unc.edu
Margolis
P A
PA
Downs
S M
SM
Bordley
W C
WC
D000550:Amblyopia / Q000175:diagnosis*; D002675:Child, Preschool; D006801:Humans; D008403:Mass Screening; D012680:Sensitivity and Specificity