Pediatric amblyopia risk investigation study (PARIS)

Howard I. Savage, Hester H. Lee, Deneen Zaetta, Ronald Olszowy, Ellie Hamburger, Mark Weissman, Kevin Frick

Research output: Contribution to journalArticle

Abstract

• PURPOSE: To assess the learning curve, testability, and reliability of vision screening modalities administered by pediatric health extenders. • DESIGN: Prospective masked clinical trial. • METHODS: Two hundred subjects aged 3 to 6 underwent timed screening for amblyopia by physician extenders, including LEA visual acuity (LEA), stereopsis (RDE), and noncycloplegic autorefraction (NCAR). Patients returned for a comprehensive diagnostic eye examination performed by an ophthalmologist or optometrist. • RESULTS: Average screening time was 5.4 ± 1.6 minutes (LEA), 1.9 ± 0.9 minutes (RDE), and 1.7 ± 1.0 minutes (NCAR). Test time for NCAR and RDE fell by 40% during the study period. Overall testability was 92% (LEA), 96% (RDE), and 94% (NCAR). Testability among 3-year-olds was 73% (LEA), 96% (RDE), and 89% (NCAR). Reliability of LEA was moderate (r = .59). Reliability of NCAR was high for astigmatism (Cyl) (r = .89), moderate for spherical equivalent (SE) (r = .66), and low for anisometropia (ANISO) (r = .38). Correlation of cycloplegic autorefraction (CAR) with gold standard cycloplegic retinoscopic refraction (CRR) was very high for SE (.85), CYL (.77), and moderate for ANISO (.48). • CONCLUSIONS: With NCAR, physician extenders can quickly and reliably detect astigmatism and spherical refractive error in one-third the time it takes to obtain visual acuity. LEA has a lower initial cost, but is time consuming, moderately reliable, and more difficult for 3-year-olds. Shorter examination time and higher reliability may make NCAR a more efficient screening tool for refractive amblyopia in younger children. Future study is needed to determine the sensitivity and specificity of NCAR and other screening methods in detecting amblyopia and amblyopia risk factors.

Original languageEnglish (US)
Pages (from-to)1007-1013
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume140
Issue number6
DOIs
StatePublished - Dec 2005

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Amblyopia
Pediatrics
Anisometropia
Mydriatics
Physician Assistants
Astigmatism
Visual Acuity
Vision Screening
Depth Perception
Learning Curve
Refractive Errors
Clinical Trials
Costs and Cost Analysis
Sensitivity and Specificity
Health

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Savage, H. I., Lee, H. H., Zaetta, D., Olszowy, R., Hamburger, E., Weissman, M., & Frick, K. (2005). Pediatric amblyopia risk investigation study (PARIS). American Journal of Ophthalmology, 140(6), 1007-1013. https://doi.org/10.1016/j.ajo.2005.06.034

Pediatric amblyopia risk investigation study (PARIS). / Savage, Howard I.; Lee, Hester H.; Zaetta, Deneen; Olszowy, Ronald; Hamburger, Ellie; Weissman, Mark; Frick, Kevin.

In: American Journal of Ophthalmology, Vol. 140, No. 6, 12.2005, p. 1007-1013.

Research output: Contribution to journalArticle

Savage, HI, Lee, HH, Zaetta, D, Olszowy, R, Hamburger, E, Weissman, M & Frick, K 2005, 'Pediatric amblyopia risk investigation study (PARIS)', American Journal of Ophthalmology, vol. 140, no. 6, pp. 1007-1013. https://doi.org/10.1016/j.ajo.2005.06.034
Savage HI, Lee HH, Zaetta D, Olszowy R, Hamburger E, Weissman M et al. Pediatric amblyopia risk investigation study (PARIS). American Journal of Ophthalmology. 2005 Dec;140(6):1007-1013. https://doi.org/10.1016/j.ajo.2005.06.034
Savage, Howard I. ; Lee, Hester H. ; Zaetta, Deneen ; Olszowy, Ronald ; Hamburger, Ellie ; Weissman, Mark ; Frick, Kevin. / Pediatric amblyopia risk investigation study (PARIS). In: American Journal of Ophthalmology. 2005 ; Vol. 140, No. 6. pp. 1007-1013.
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