Comparison of the Refractive Measurements with Hand-held Autorefractometer, Table-mounted Autorefractometer and Cycloplegic Retinoscopy in Children

Akıl, Handan; Keskin, Soner; Çavdarlı, Cemal

doi:10.3341/kjo.2015.29.3.178

Cited by 26 publications

(34 citation statements)

References 21 publications

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“…Cycloplegic retinoscopy reveals significantly more hyperopia than is found under non-cycloplegic conditions, in line with previous studies using pre-and post-cycloplegic autorefraction, both in children and adults, 1,[13][14][15][16][17][18][19][20][21][22][23][24][25][26] with the mean difference reported by the present study (0.59 AE 0.51DS) similar to autorefraction values. 18,25 As found using autorefraction, the largest differences were demonstrated in the present study's youngest participants (6)(7) year-olds), with differences reducing significantly as age increased up to 12-13 years.…”

Section: Discussionsupporting

confidence: 92%

“…[9][10][11][12] Previous studies evaluating the difference between cycloplegic and non-cycloplegic measurement of refractive error have focused on the use of autorefraction measures in the context of epidemiological classification of refractive error or compared refractive measurement techniques and/or cycloplegic regimes. 1,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Outcomes from epidemiological studies using autorefraction for categorisation purposes are not relevant in the context of using retinoscopy to establish refractive error, either as a basis for undertaking a subjective refraction and/or for prescribing spectacles.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of retinoscopy results with and without 1% cyclopentolate in school‐aged children

Doherty

Doyle

McCullough

et al. 2019

Ophthalmic Physiologic Optic

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Purpose This study was designed with the aim of providing practitioners with an evidence base to inform their clinical decision making as to when cycloplegic retinoscopy is necessary and when it might be appropriate to forgo. The study aimed to determine the age at which there ceases to be a clinically significant difference between cycloplegic and non‐cycloplegic retinoscopy and whether age, refractive error, habitual spectacle wear and accommodation influence the relationship. Methods A single examiner carried out cycloplegic and non‐cycloplegic retinoscopy on 128 children stratified into four age groups (6–7, 8–9, 10–12 and 12–13 years). Cycloplegia was achieved using 1% cyclopentolate and retinoscopy carried out after 30 min. The examiner was masked to the lenses used and to habitual spectacle wear. Accommodation was assessed using dynamic retinoscopy prior to cycloplegia. Results Cycloplegic and non‐cycloplegic sphere differed significantly (z = −9.18, p < 0.0001). Although the difference decreased significantly as age increased (χ2 = 16.57, p = 0.0009), cycloplegic retinoscopy revealed more hyperopia than non‐cycloplegic retinoscopy in all age groups (p < 0.0001). The difference between cycloplegic and non‐cycloplegic results was greater where ‘high’ hyperopia (≥+2.50DS) was present (F1,6 = 12.86, p = 0.0005), and as hyperopia increased the difference increased (Spearman's ρ = 0.55, p < 0.0001). Neither spectacle wear (p = 0.74) nor accommodation (p = 0.08) influenced the difference between spherical measures. Measures of astigmatic error did not differ significantly (z = −1.59, p = 0.11). A non‐cycloplegic sphere ≥+1.50DS was relatively sensitive (87%) and specific (96%) at indicating clinically significant hyperopia (≥+2.50D) as revealed by cycloplegic retinoscopy. Conclusions Cyclopentolate 1% does not impact the cylindrical component of the retinoscopy result, but reveals significantly more hyperopia in the spherical component, both statistically and clinically in children aged 6–13 years. Differences between cycloplegic and non‐cycloplegic sphere increase significantly with increasing hyperopia, independent of spectacle wear and accommodation. A non‐cycloplegic retinoscopy result of ≥+1.50DS may be used by practitioners wishing to identify children aged 6–13 years at risk of clinically significant hyperopia (≥+2.50DS), but cycloplegia is required to accurately ascertain the full spherical error.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Comparison of retinoscopy results with and without 1% cyclopentolate in school‐aged children

Doherty

Doyle

McCullough

et al. 2019

Ophthalmic Physiologic Optic

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“…In a similar study, Ying et al 21 compared noncycloplegic retinoscopy, Retinomax, and SureSight Vision Screener (Welch Allyn Medical Products) for preschool vision screening and reported that all of the devices had similar and high accuracy in detecting vision disorders in preschoolers across all types of screeners and ages of children. Akil et al 22 found good agreement between the Retinomax K-plus 3 with cycloplegia and cycloplegic retinoscopy. In the same study, when Bland-Altman analysis was performed to compare the spherical equivalent values before and after cycloplegia was measured with the Retinomax K-plus 3, Canon RK-F1, and cycloplegic retinoscopy, almost all of the differences between the measurements remained within the range of ±2 standard deviations, on average.…”

Section: Resultsmentioning

confidence: 96%

“…In the same study, when Bland-Altman analysis was performed to compare the spherical equivalent values before and after cycloplegia was measured with the Retinomax K-plus 3, Canon RK-F1, and cycloplegic retinoscopy, almost all of the differences between the measurements remained within the range of ±2 standard deviations, on average. 22 Harvey et al 23 reported that the Retinomax provided an average of approximately 0.25 D less negative or more positive measures of refractive error than retinoscopy. They also compared their data to other reports and found that the Retinomax was concordant with retinoscopy and subjective refinement in young children, to the degree that is comparable with other autorefractors (Humphrey 500 and Nidek AR-1000).…”

Section: Resultsmentioning

confidence: 99%

A Comparison of Three Different Photoscreeners in Children

Teberik¹,

Eski²,

Kaya³

et al. 2018

J Pediatr Ophthalmol Strabismus

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“…The traditional method for diagnosing refractive defects in childhood is cycloplegic retinoscopy performed by an experienced ophthalmologist. However, this requires a long period of time and patient compliance, and this method can be difficult, even for experienced ophthalmologists (2,3). Therefore, efforts are being exerted to develop alternative tools to retinoscopy that require minimal patient cooperation and allow for faster and easier evaluation in clinics with a high workload.…”

Section: Introductionmentioning

confidence: 99%

Handyref-K: Comparison of the Latest Handheld Autorefractokeratometer in Patients Younger than Three Years of Age with Retinomax and PlusOptix

seymen¹

2019

Beyoglu Eye J

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The purpose of the study was to compare the refractive error measurements of pediatric patients performed with a Plusoptix A09 photorefractor (PO; Plusoptix AG, Nuremberg, Germany), a Retinomax K-plus 3 (RTX; Right Group, Tokyo, Japan), and the new handheld auto refracto-keratometer, the Nidek HandyRef-K (HDY; Nidek SA, Créteil, France), and to evaluate the intermethods agreement. Methods: A total of 194 eyes of 194 children were included in the study. All of the children underwent refraction measurement with the PO before cycloplegia and 2 autorefractors were used after cycloplegia: the RTX and the HDY. Results: The mean age of the patients was 16.65±10.04 months (range: 3-34 months). There were no statistically significant differences between the spherical values (SV) or cylindrical axis values (CAV) measured with the PO (SV: 1.61±1.79 diopters [D]; CAV: 94.25±72.47 D), the RTX (SV: 1.91±2.06 D; CAV: 94.3±73.44 D), and the HDY (SV: 1.89±2.04 D; CAV: 93.55±73.71 D) (p>0.05).There was a statistically significant difference in the cylindrical values (CV) assessed with the RTX (CV:-0.97±0.75 D) and the HDY (CV:-1.11±0.76 D) (p=0.003) and the HDY and the PO (CV:-0.92±0.68 D) (p=0.002), while there was no statistically significant difference between the values determined with the RTX and the PO (p>0.05). Statistically significant differences were demonstrated for spherical equivalent values (SEV) obtained with the RTX (SEV: 1.43±1.97 D) and the PO (SEV: 1.15±1.74 D) (p=0.02), and the HDY (SEV: 1.34±1.95 D) and the PO (p=0.03), but no significant difference was found between the RTX and the HDY values (p>0.05). Conclusion: No significant difference was found between the SEV measured by the RTX and the HDY, but the PO was significantly less hyperopic than the RTX and the HDY. The CV measured by HDY was higher than that of other devices. These devices can be used for screening in crowded pediatric ophthalmology clinics and may be an easier way of measuring refractive errors in children younger than 3 years of age, but high SEV and CV results should serve as an alert to physicians. It should also be kept in mind that cycloplegic retinoscopy is still the gold standard and these alternative methods can only be used for screening. The prescription of eyeglasses should not be made without cycloplegic retinoscopy.

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Comparison of the Refractive Measurements with Hand-held Autorefractometer, Table-mounted Autorefractometer and Cycloplegic Retinoscopy in Children

Cited by 26 publications

References 21 publications

Comparison of retinoscopy results with and without 1% cyclopentolate in school‐aged children

Comparison of retinoscopy results with and without 1% cyclopentolate in school‐aged children

A Comparison of Three Different Photoscreeners in Children

Handyref-K: Comparison of the Latest Handheld Autorefractokeratometer in Patients Younger than Three Years of Age with Retinomax and PlusOptix

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