The goal of vision screening in young children is to eliminate preventable blindness and identify treatable conditions early enough to implement effective intervention. The American Academy of Pediatrics (AAP) has recently endorsed the need for more extensive studies of photoscreening technologies as a specific tool for increasing the currently low national rate of vision screening in young children (AAP, 2002). There are a number of different photoscreening optical devices that have been used in both general population screening and with specific clinical populations. Results from the available studies vary dramatically in terms of sensitivity, specificity, and predictive values, and none of the current technology meets the standards required for universal acceptance (Freedman and Preston, 1992; Atkinson, et al., 1996); Tong, et al., 1998; Simons, et al., 1999; Granet, et al., 1999; Watts, et al., 1999; Enzenauer, et al., 2000; Hartmann, et al., 2000).
The purpose of the proposed study is to use a new device, the AMT Ocular Biometer, which is a combined wavefront sensing and eye tracking apparatus. This instrument is capable of dynamically measuring ocular alignment and accommodation of both eyes simultaneously. It can be accurately thought of as a dual video recorder. The subject looks through a glass window at real targets for a period of 30 seconds. The videotape is processed to evaluate ocular alignment and refraction of each eye using a computer program. It is only necessary to get good pictures when and if the child is looking at the targets. We propose to evaluate this device in a pediatric primary care setting as a vision screening tool with very young children. Children between 3 and 6 years of age will be tested using the Ocular Biometer and the findings will be compared with results from a comprehensive, dilated eye examination. Children will be recruited from the Pediatric Clinics in the College of Osteopathic Medicine. The complete eye examination will be performed in the Pediatric and Binocular Vision Clinic in the College of Optometry. This work will be a collaborative effort within Nova Southeastern University between the Colleges of Optometry and Osteopathic Medicine, as well as an external collaboration with AMT Technologies Corp., the developer of the Ocular Biometer. The study is designed to evaluate the specificity and sensitivity of the device as well as its efficacy in the primary care setting for vision screening. The findings of this work are expected to launch a sophisticated, state-of-the-art vision screening technology into the primary care setting.