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Denis Pelli, Shuang Song, Dennis Levi; Improving the screening of children for amblyopia. Journal of Vision 2011;11(11):411. doi: 10.1167/11.11.411.
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Large trials in Israel and Sweden have demonstrated a very favorable cost-benefit ratio in screening children for amblyopia. Song, Levi, and Pelli (in prep.) find that the foveal vision of strabismic amblyopes is well-modeled by the crowding of normal peripheral vision. That finding on adults indicates that two improvements to existing charts would greatly increase their diagnostic sensitivity to strabismic amblyopia in children, with no loss of specificity. First, the flankers should be letter-like, not bars. Second, the flankers should be closer to the target letter, i.e. more tightly spaced. Atkinson's Cambridge Crowding Cards are exemplary in this regard, having the tightest spacing of all commercially available tests. These principles will be proven by demonstration at the presentation.
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