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J Pediatr Ophthalmol Strabismus. 1999 Sep-Oct;36(5):251-6.

A new objective digital computerized vision screening system.

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Ratner Children's Eye Center, Department of Ophthalmology, University of California San Diego, La Jolla 92093-0946, USA.



Fewer than 40% of children in the crucial younger-than-4 age group are evaluated for visual problems by pediatricians. This is due to impracticality from either a clinical or practice efficiency standpoint. Current photoscreening methods require trained readers and suffer from significant subjectivity and interobserver variability. We report a cross-sectional, double-masked study using new digital imaging with objective, automated, computerized image analysis.


Two-hundred six children aged 9 months to 16 years were prospectively studied in a University-based pediatric ophthalmology practice. Images were taken by volunteers with a modified digital camera which, when downloaded, were analyzed within 35 seconds by new image analysis software. The analysis was compared to a masked review of a complete pediatric ophthalmic exam.


Overall agreement between physician and the objective computerized analysis was 86.9%. Positive predictive value was 91%, sensitivity was 89%, and specificity was 83%.


This automated digital imaging screening system eliminates human bias and provides accurate and immediate results. The system requires no special expertise.

[Indexed for MEDLINE]

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