Can the Bruckner test be used as a rapid screening test to detect significant refractive errors in children?

• Main Author: Kothari Mihir
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2007-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Amblyopia; Brückner test; photorefraction; refractive error; vision screening.
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2007;volume=55;issue=3;spage=213;epage=215;aulast=Kothari

<b>Purpose: </b> To assess the suitability of Br&#x00FC;ckner test as a screening test to detect significant refractive errors in children. <b> Materials and Methods:</b> A pediatric ophthalmologist prospectively observed the size and location of pupillary crescent on Br&#x00FC;ckner test as hyperopic, myopic or astigmatic. This was compared with the cycloplegic refraction. Detailed ophthalmic examination was done for all. Sensitivity, specificity, positive predictive value and negative predictive value of Br&#x00FC;ckner test were determined for the defined cutoff levels of ametropia. <b> Results:</b> Ninety-six subjects were examined. Mean age was 8.6 years (range 1 to 16 years). Br&#x00FC;ckner test could be completed for all; the time taken to complete this test was 10 seconds per subject. The ophthalmologist identified 131 eyes as ametropic, 61 as emmetropic. The Br&#x00FC;ckner test had sensitivity 91&#x0025;, specificity 72.8&#x0025;, positive predictive value 85.5&#x0025; and negative predictive value 83.6&#x0025;. Of 10 false negatives four had compound hypermetropic astigmatism and three had myopia. <b> Conclusions:</b> Br&#x00FC;ckner test can be used to rapidly screen the children for significant refractive errors. The potential benefits from such use may be maximized if programs use the test with lower crescent measurement cutoffs, a crescent measurement ruler and a distance fixation target.