Validity of the Bruckner reflex in the detection of amblyopia.
OBJECTIVE
To establish the sensitivity and specificity of the Bruckner reflex (comparison of the fundus red reflexes) in the detection of amblyopia or its risk factors.


METHODS
A single masked study using a medical student's diagnostic ability against the gold standard of a full clinical examination by a paediatric ophthalmologist.


METHODS
A university teaching hospital outpatient facility.


METHODS
Three hundred and one patients consecutively referred for ophthalmic assessment.


RESULTS
The sensitivity of the test for the detection of children with amblyopia risk factors was 86% and the specificity was 65%. Of 70 children with a definite diagnosis of amblyopia, the sensitivity of the test was 95%.


CONCLUSIONS
The Bruckner reflex is a useful screening test for primary eye care personnel. However, there is a significant false-positive rate which will result in unnecessary referrals. We recommend that it form part of a battery of tests, including, for example, the modified base down prism test, which are useful in assessing the vision of preverbal children.
Gole
G A
GA
Department of Ophthalmology, Royal Children's Hospital, Herston Road, Brisbane 4029, Queensland.
Douglas
L M
LM
D000293:Adolescent; D000550:Amblyopia / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003941:Diagnostic Techniques, Ophthalmological; D005189:False Positive Reactions; D005654:Fundus Oculi; D006801:Humans; D007223:Infant; D009887:Ophthalmoscopy / Q000379:methods; D011237:Predictive Value of Tests; D012018:Reflex; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity