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The need and application of the Brueckner screening by pediatric primary health care providers

1 December 2004


The prevalence of visual disorders among children is significant. Amblyopia is a significant cause of vision loss in children and is best treated or prevented during the first five years of childhood. There is a need for a quick, objective and accurate screening tool to identify visually impairing conditions that are not typically found during elementary school vision screenings. The Brueckner method along with refractive screening with the direct ophthalmoscope are efficient means of identifying children that may have amblyopia or have visual conditions that place them at risk for amblyopia. With some practice, this technique can be mastered by health care providers in primary care settings. There is an excellent opportunity to apply this screening during well-child checks without a significant time impact to the office visit. Since all pediatric care settings are equipped with an ophthalmoscope, there is no additional cost associated with using this technique. The relatively high sensitivity of this technique when performed by a practiced observer means that fewer kids will be missed who may be at risk. The high specificity of this test means that there will be fewer false positive referrals. A training curriculum has been prepared to train pediatric health professionals in the Brueckner method. Learning and employing the Brueckner screening tool will facilitate primary health care providers in helping to meet the goal of improving children's vision.


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