Sensitivity and specificity of the mti photoscreener in a preschool population with a high prevalence of astigmatism

Purpose To determine the sensitivity and specificity of the MTI Photoscreener for screening a Native American preschool population known to have a high prevalence of astigmatism Methods The undilated eyes of 77 Tohono O'Odham children (31/2 to 5 years old) were photographed in a dimly lit room using the MTI. Each child also underwent a complete eye examination, including cycloplegic refraction using the Nikon Retinomax K-plus. The MTI photographs were scored as 'pass' or 'fail' by three of the investigators according to instructions in the MTI manual. Results of the eye exam were scored as 'fail1 if ocular pathology or significant refractive error (based on a survey of pédiatrie ophthalmologists by Miller and Harvey, 1997) was detected Results. Thirty subjects failed the eye exam due to high astigmatism and one had a unilateral cataract. Rater # I Rater #2 Rater #3 Sensitivity 83.9% 61.3% 80.6% Specificity 80.4% 89 1% 87.0% The 9 photographs that could not be interpreted due to poor quality were scored as 'fails' Conclusions The MTI Photoscreener is a useful screening device, however, the photographs can be difficult to interpret as shown by the variability in sensitivity and specificity amongst novice raters.