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Ophthalmology. 2009 Jan;116(1):145-53. doi: 10.1016/j.ophtha.2008.08.031. Epub 2008 Oct 29.

Fixation preference and visual acuity testing in a population-based cohort of preschool children with amblyopia risk factors.

Author information

  • 1Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033-9224, USA.

Erratum in

  • Ophthalmology. 2009 Feb;116(2):174.

Abstract

PURPOSE:

To compare the clinical assessment of fixation preference (FP) to visual acuity (VA) in a population-based sample of preschool children with amblyopia risk factors.

DESIGN:

Evaluation of diagnostic test in a population-based study.

PARTICIPANTS:

243 children with anisometropia and/or strabismus, aged 30 to 72 months, living in Los Angeles County, CA [corrected]

METHODS:

Before measuring VA, FP testing was performed at near and usually without correction, using the binocular fixation pattern in children with strabismus >10 prism diopters (Delta), or the induced tropia test for children with strabismus <or=10Delta or without strabismus. We determined the sensitivity and specificity of FP testing for predicting unilateral amblyopia, defined by optotype VA, among children with amblyopia risk factors.

MAIN OUTCOME MEASURE:

Grade of FP.

RESULTS:

Sensitivity of FP testing for amblyopia among children with anisometropia was 20% (9/44) and specificity was 94% (102/109). Among strabismic children, sensitivity was 69% (9/13; worse in children 30-47 than 48-72 months old) and specificity was 79% (70/89), with similar findings for esotropia and exotropia.

CONCLUSION:

The ability of FP testing to correctly identify amblyopia in preschool children with amblyopia risk factors is poor. Clinicians should be wary of using FP as a surrogate measure of interocular difference in VA in young children.

FINANCIAL DISCLOSURE(S):

The authors have no proprietary or commercial interest in any materials discussed in this article.

PMID:
18962921
[PubMed - indexed for MEDLINE]
PMCID:
PMC2699252
Free PMC Article
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