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. 2024 Apr 2:18:989-996.
doi: 10.2147/OPTH.S453207. eCollection 2024.

Determination of Refractive Error Using Direct Ophthalmoscopy in Children

Sruthi Vijendran #  1 , Yogish S Kamath #  1 , Yash Alok  2 , Neetha I R Kuzhuppilly  1
Affiliations

Determination of Refractive Error Using Direct Ophthalmoscopy in Children

Sruthi Vijendran et al. Clin Ophthalmol. .

Abstract

Purpose: Refractive error is a major cause of visual impairment in children and its early detection can prevent ocular morbidity such as amblyopia and strabismus. Brückner test is a comprehensive test which can be easily administered in children using a direct ophthalmoscope. We aimed to determine refractive error in children by analysis of the red reflex using modified Brückner test.

Patients and methods: This prospective observational study was conducted on 683 undilated eyes of 683 children aged four to 10 years. They were evaluated with a direct ophthalmoscope from one meter in a dimly lit room. The characteristics of the red reflex and crescent obtained were compared with photoscreener refraction value and analyzed.

Results: The presence of superior crescent was associated with hypermetropia (Chi square 37.11, p < 0.001, kappa = 0.15) and inferior crescent with myopia (Chi square 157.29, p < 0.001, kappa = 0.477). Superior crescent was 98.4% sensitive in detecting hypermetropia. Hypermetropia greater than +1.5D, was associated with larger superior crescent crossing horizontal midline of pupil (Chi square = 5.29, p = 0.021).

Conclusion: The modified Brückner test is useful in detection and quantification of refractive error in children. It is easy, simple, quick and can be employed in the community as a screening test to detect potentially amblyogenic refractive errors.

Keywords: Brückner test; hypermetropia; myopia; pediatric refraction; refractive error; visual impairment.

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Conflict of interest statement

Yogish S Kamath and Neetha Kuzhuppilly report grants from Indian Council of Medical Research (ICMR). The authors report no other conflicts of interest in this work.

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