title: Non-cycloplegic screening for amblyopia via refractive findings with the Nikon Retinomax hand held autorefractor in 3 year old kindergarten children.
abstract: OBJECTIVE
  To assess non-cycloplegic screening for amblyopia with the hand held Nikon Retinomax autorefractor in 3 year old kindergarten children.
  
  
  METHODS
  427 three year old children were examined in kindergarten with the Retinomax without cycloplegia. A gold standard was established in all children by two orthoptic examinations in kindergarten. If there were missing, abnormal, or inconsistent findings, children were referred for ophthalmological examination. If, by the ophthalmological examination, a new case of amblyopia requiring treatment was diagnosed, the gold standard was set "positive."
  
  
  RESULTS
  In 404 children the gold standard was obtained. 10 children (2.5%) had a "positive" gold standard of unknown and untreated amblyopia. Screening sensitivity was 0.80, specificity 0.58, accuracy 0.58, and the likelihood ratio 1.89.
  
  
  CONCLUSIONS
  Non-cycloplegic refractive screening with the Retinomax led to many false positive referrals due to instrument myopia and "inconclusive" results. Hence specificity, accuracy, and the likelihood ratio were too low to conduct screening effectively.
authors.affiliation: Strabismology Department, Medical Faculty Tübingen, University of Tübingen, Tübingen, Germany. jc.barry@med.uni-tuebingen.de
authors.forename: J C
authors.initials: JC
authors.lastname: Barry
authors.forename: H H
authors.initials: HH
authors.lastname: König
mesh_terms: D000550:Amblyopia / Q000175:diagnosis*; D019985:Benchmarking; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D009184:Mydriatics; D009885:Ophthalmology / Q000295:instrumentation*; D012029:Refraction, Ocular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D009184:Mydriatics