Detecting cataract causing visual impairment using a nonmydriatic fundus camera.

Abstract

To assess the validity of a digital nonmydriatic fundus camera in detecting cataract as a cause of visual impairment. Diagnostic test comparison. Photos of the anterior segment of 72 eyes were taken with a nonmydriatic fundus camera and assessed for cataract by two graders. Dilated biomicroscopy examination of the anterior segment of the same 72 eyes was then performed and cataract graded using the Wilmer scale. Grader 1 and 2 reported 90% and 94% sensitivity and 82% and 77% specificity, respectively, when the digital photos were compared with slit-lamp biomicroscopy in determining visually significant cataract. In addition, both graders showed similar substantial agreement between the digital photos and slit-lamp biomicroscopy when assessed for cataract (unweighted kappa 0.87 and 0.92, respectively, for graders 1 and 2). The nonmydriatic fundus camera may be an alternative method for screening for visually significant cataract in the community.