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S. S. Block, A. Needham, S. Peterson; Comparison of Results of the Randot Stereo Smile Test II to the Random Dot "E" Test of Stereopsis in a Screening Setting. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5533.
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The purpose is to compare the results of the Randot Stereo Smile Test II (Smile) to the Random Dot "E" (RDE)in a subjects with intellectual disability. The VIP study suggested that the Stereo Smile Test is a more sensitive measure for detecting amblyopia, strabismus, refractive error or reduced visual acuity in a screening setting. Both tests are appropriate for persons with impaired cognitive ability.
Special Olympics athletes participating at the IL Games (6/06) and the US National Games (7/06) were invited to participate. The screening is standardized to include visual acuity, cover test, stereopsis, color vision, and internal (nondilated) and external eye health assessment. The stereo tests were individually randomly presented sequentially to each athlete. Testing followed the instructions included with each test. 186 athletes (81 females, 105 males) aged 8 - 70 years participated in the study.
The Smile test passed 30 subjects that failed the RDE. Five of these were strabismic. The RDE passed 12 athletes that failed the Smile test. Three of these were strabismic. Sensitivity, specificity, positive predictive values are as follows for a 2 or more line difference in distance acuity(VA), strabismus at 3 meters (far) or 40 cm. (near):
While recent research suggests that the Random Dot "E" may not be as sensitive a measure as the Stereo Smile Test II, caution is suggested. The results of this study suggest that neither screening measures are good for identifying a 2 or more line difference in distance visual acuity between eyes as noted by the low sensitivity figures. However, the sensitivity is better for detecting strabismus but specificity being low suggests there may be some overreferrals for strabismus.
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