PHOTOGRAPHIC SCREENING FOR STRABISMUS AND HIGH REFRACTIVE ERRORS OF CHILDREN AGED 1–4 YEARS

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Abstract
182 children (age 1–4 years) were photographed by health sisters at the annual screening at the children's health care center as described by Kaakinen (1979). The photographs were examined by an ophthalmologist to diagnose squint and/or refractive error cases based on the typical changes in the corneal and fundus reflexes. The cases found in this way were controlled clinically. Results: 7 pathological cases were detected: 2 esotropias, 1 microesotropia, 2 hyperopias of both eyes, 2 anisocorias. False positive were 6 cases, from which 4 were false positive microstrabismus suspects and 2 cases with asymmetrical fundus reflexes, which were normal. 14 cases failed (9 (4.9%) looked to the side, and 5 (2.7%) were technical failures). For the reliability of the method, a random sample of 20 children, who had normal corneal and fundus reflexes were examined clinically. No anisometropia of over 0.5 diopters appeared among these 20 control cases, and the highest hyperopic and astigmatic errors that appeared were + 1.75 diopters. All the astigmatic cases were combined with a slight myopia of ‐0.5––1.0 diopters in each case. No higher myopias occurred in this group, and all these 20 children had straight eyes with the cover test at near fixation.