Article Date: 2/1/2001

Think Pediatrics

This instrument is a shoo-in for evaluating children. See why.
By Philip M. Buscemi, O.D.

I recently found out that my nephew and his wife are going to have a baby. I was delighted. Then I started thinking about the hurdles that new parents face. One that I immediately thought of was vision problems, especially amblyopia.

How often have you seen an uncooperative, angry 2-year-old who you'd like to check for significant anisometropia? How many times have you told parents, "If we'd seen your daughter earlier, we would have had a better chance of helping"?

A noble cause

Marco Ophthalmic sees the PhotoScreener as an invaluable tool to help reduce the rate of pediatric vision loss in the 1 in 20 kids who have sight-threatening visual disorders. The instrument uses static retinos-copy to record the light reflex from a child's pupils onto Polaroid film.

By rotating the slit-shaped strobe 90 degrees in two consecutive photos, you can use the shape and position of the eyes' reflexes to determine the child's type of refractive error. You can also diagnose opacities such as cataracts in the optical media and can detect strabismus.

AOA recommendation

The American Optometric Association says that all infants should be evaluated for visual problems by an optometrist by 6 months of age or sooner if abnormalities are present. But most O.D.s don't pursue these young patients because they perceive them as being hard to examine. They also feel that they tend to upset the flow of the practice. Plus, these kids aren't likely to buy expensive glasses.

Ethically and morally you may want to help, but the practical aspects make it difficult. Enter the PhotoScreener, making a seemingly difficult task less complicated.

The PhotoScreener is perfect for working with children.

How it works

The device has a simple-to-use aiming light that projects two arrow-shaped tips pointing at each other on to the child's forehead. A multi-colored flashing light and optional sound keeps the child's attention. Push the button and take the picture. Pop out the film and in a minute or so, you have the developed picture.

The photograph will tell you if the patient has a significant refractive error, strabismus or cataracts. Because the PhotoScreener is designed for non-physicians, your tech can easily perform the screening evaluation. You get a qualitative instant diagnosis of the child's visual condition.

The PhotoScreener gives you a hard copy to show parents. Explaining the meaning of the retinal reflexes is easy, especially with the brochure that comes with the unit.

The PhotoScreener sells for about $3,800 and comes with a hard case for transporting it to screenings.

The beauty of documentation

When a parent compares his child's picture to the one the PhotoScreener provides, you have instant credibility. The first question isn't, "Where do we get another opinion?" but, "How can you help my child?"

Also consider the medical and legal benefits. The pictures leave no doubt about the patient's condition. So if you find yourself in court, you have rock-solid documentation.

Benefiting the young

My wife teaches classes for new moms at the local hospital. Because the women often bring their older children, I'm thinking about having my wife use the PhotoScreener to take pictures and bring them home to me for analysis. This would provide a great service to her students and serve as excellent public relations for our practice.

With just a little effort, the PhotoScreener will pay for itself. And more importantly, you'll provide a great service to the youngest members of your community.

For more information, call (800) 874-5274 or visit

Dr. Buscemi has no direct financial interest in Marco Ophthalmic or in the PhotoScreener. However, in the full interest of disclosure, he sits on the board of directors of Fortune Technologies, a wholly owned subsidiary of Nidek. He also has consulting contracts with Nidek. Marco is one of Nidek's American distributors. You can reach him at Please type "OM" in the subject field and indicate the topic.

Optometric Management, Issue: February 2001