Pediatric Amblyopia Rik Invetigation tudy (PARI)

Purpoe To ae the learning curve, tetability, and reliability of viion creening modalitie adminitered by pediatric health extender. Deign Propective maked clinical trial. Method Two hundred ubject aged 3 to 6 underwent timed creening for amblyopia by phyician extender, including LEA viual acuity (LEA), tereopi (RDE), and noncycloplegic autorefraction (NCAR). Patient returned for a comprehenive diagnotic eye examination performed by an ophthalmologit or optometrit. Reult Average creening time wa 5.4 ± 1.6 minute (LEA), 1.9 ± 0.9 minute (RDE), and 1.7 ± 1.0 minute (NCAR). Tet time for NCAR and RDE fell by 40% during the tudy period. Overall tetability wa 92% (LEA), 96% (RDE), and 94% (NCAR). Tetability among 3-year-old wa 73% (LEA), 96% (RDE), and 89% (NCAR). Reliability of LEA wa moderate (r = .59). Reliability of NCAR wa high for atigmatim (Cyl) (r = .89), moderate for pherical equivalent (E) (r = .66), and low for aniometropia (ANIO) (r = .38). Correlation of cycloplegic autorefraction (CAR) with gold tandard cycloplegic retinocopic refraction (CRR) wa very high for E (.85), CYL (.77), and moderate for ANIO (.48). Concluion With NCAR, phyician extender can quickly and reliably detect atigmatim and pherical refractive error in one-third the time it take to obtain viual acuity. LEA ha a lower initial cot, but i time conuming, moderately reliable, and more difficult for 3-year-old. horter examination time and higher reliability may make NCAR a more efficient creening tool for refractive amblyopia in younger children. Future tudy i needed to determine the enitivity and pecificity of NCAR and other creening method in detecting amblyopia and amblyopia rik factor.