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Detection of Strabismus in Children

Deborah S. Nassif, PhD; Nadya V. Piskun, PhD; David G. Hunter, MD, PhD

Arch Ophthalmol. 2006;124:509-513.

Objective  To evaluate the clinical performance of the Pediatric Vision Screener (PVS) in children in a pediatric ophthalmology office setting.

Methods  Seventy-seven subjects between 2 and 18 years of age received gold-standard orthoptic examinations and were classified as at risk for amblyopia if strabismus or anisometropia (>1.50 diopters) was present. Strabismus was subclassified as variable or constant. The subjects were then tested with the PVS, which produced a pass or refer recommendation based on a binocularity score. The PVS also produced a yield score to indicate the subject's interest in the target. Sensitivity and specificity for amblyopia risk detection were calculated.

Results  Binocularity as determined by the PVS was greater than 65% for all controls and less than 20% for all subjects with constant strabismus. Binocularity ranged from 0% to 52% in subjects with variable strabismus. All subjects with anisometropia and no strabismus had binocularity scores less than 10%.

Conclusions  The PVS identified strabismus, when present, in all subjects and identified 3 subjects with anisometropia as well. The PVS shows potential to address a lack of screening instrumentation appropriate for use with preschool-aged children.

Author Affiliations: Department of Ophthalmology, Children's Hospital Boston, Harvard Medical School, Boston, Mass.

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