The Effectiveness of the Bruckner Test in the Early Detection of Refractive Errors and Potential Amblyopia in Children Aged 7–18 Years at Citra Husada Hospital Jember

Abstract

Refractive errors and potential amblyopia in children are often detected late due to the lack of practical screening access. This study aims to evaluate the effectiveness of the bruckner test as a screening tool for early detection of refractive errors and potential amblyopia in school-aged children. An analytical observational study with a cross-sectional design was conducted on 50 children (aged 7–18 years) at Citra Husada Hospital, Jember, from October to November 2025. Each subject underwent a non-cycloplegic bruckner test and a subjective refraction examination as the gold standard. Data were analyzed using 2×2 contingency tables, statistical tests, and the Kappa coefficient via SPSS version 25 software. A total of 86% of subjects (43 children) showed a positive bruckner test result (asymmetric reflex), with the most dominant reflex pattern being a decentered crescent (40%). These findings were consistent with subjective refraction results, where 86% of subjects were initially identified with ametropia. The bruckner test demonstrated high diagnostic performance with a sensitivity of 95.56%, specificity of 100%, and an accuracy of 96%. Statistical analysis revealed an almost perfect agreement between the brckner test and the gold standard (κ = 0,811; p < 0,001). The Brückner test is highly effective and accurate as a screening tool for the early detection of refractive errors in school-aged children within secondary healthcare facilities. The implementation of this method is strongly recommended as part of routine screening to reduce the delay in managing visual impairments in children.