Predictive value of inexpensive digital eye and vision photoscreening: "PPV of ABCD".

PURPOSE: Some consumer digital cameras have short flash to lens distances (dimensions) ideal for photoscreening so we adopted them into an ongoing Alaska state wide vision screening program, the Alaska Blind Child Discovery (ABCD) Project. METHODS: Digital cameras with short flash-lens distance were employed by lay screeners trained by a DVD movie. Confirmatory eye examinations by AAPOS (American Association for Pediatric Ophthalmology and Strabismus) criteria were sought from eye doctors. RESULTS: 2900 children were screened in 62 clinics by 14 screeners. Of the 2900 screenings, 99% were readable with 6% refereed as positive for ocular pathology. The positive predictive value was estimated as greater than 80%. The per-screening image cost was less than $0.10 (10 cents) including cameras. Some screeners interpreted images similar to central reading center. CONCLUSION: Pre-literate community eye and vision photoscreening can be both valid and cost effective.

Radio-opaque modification/substitute for the wright superior oblique tendon extender for superior oblique muscle overaction strabismus.

Kenneth Wright developed a technique for graded weakening of the superior oblique by increasing the effective length of this extraocular muscle's long tendon with a piece of silicone rubber retinal encircling band commonly used by eye surgery for retinal detachment repairs. In the absence of any specific retinal bands in our Children's Hospital, the following technique was developed affording a non-invasive ability to monitor, which was less intricate than the technique so well described by Demer. We substituted the "Mini Vessel Loop" (by Maaxxim Medical or Henley International). It is an elastic smooth silicone rubber cord that is radio-opaque, and can easily be seen on X-rays and CT scans. It is not an ophthalmologic medical device but it rather is designed to loop around and identify and gently retract blood vessels and nerves in any form of surgery where needed. We demonstrated success similar to that achieved by Wright in 43 patients using these radio-opaque, silicon Mini Vessel loops.