Testability of refraction, stereopsis, and other ocular measures in preschool children: The Sydney Paediatric Eye Disease Study

Pai, Amy; Rose, Kathryn A.; Samarawickrama, Chameen; Fotedar, Reena; Burlutsky, George; Varma, Rohit; Mitchell, Paul

doi:10.1016/j.jaapos.2011.09.017

Cited by 27 publications

(23 citation statements)

References 31 publications

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“…10,11,15,16,27,28 Although the Sydney Paediatric Eye Disease (SPED) Study 27 showed an overall higher testability for the Lang-Stereotest II, only children younger than 30 months were administered the Stereo Smile II, whereas children of all ages (aged 6 to 72 months) were administered the Lang-Stereotest II. It is also not clear whether the actual SPED test procedure used for the Stereo Smile II included the use of the Demonstration Card (A) or a shortened format.…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that the RPST “was found to be most reliable in detecting ocular conditions” but only performed the Stereo Smile II on a smaller subset of less testable children (younger than 30 months or those unable to complete the RPST) with a very low prevalence of vision disorders, whereas the RPST was only performed on older, more cooperative children (aged 30 to 72 months). 27 In contrast, the VIP Study included a very large cohort of preschool children with vision disorders over a smaller age range (aged 36 to 59 months) that also included children with a significant refractive error.…”

Section: Discussionmentioning

confidence: 99%

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Stereoacuity of Preschool Children with and without Vision Disorders

Ciner¹,

Ying²,

Kulp³

et al. 2014

Optometry and Vision Science

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Purpose To evaluate associations between stereoacuity and presence, type, and severity of vision disorders in Head Start preschool children and determine testability and levels of stereoacuity by age in children without vision disorders. Methods Stereoacuity of children aged 3 to 5 years (n = 2898) participating in the Vision in Preschoolers (VIP) Study was evaluated using the Stereo Smile II test during a comprehensive vision examination. This test uses a two-alternative forced-choice paradigm with four stereoacuity levels (480 to 60 seconds of arc). Children were classified by the presence (n = 871) or absence (n = 2027) of VIP Study–targeted vision disorders (amblyopia, strabismus, significant refractive error, or unexplained reduced visual acuity), including type and severity. Median stereoacuity between groups and among severity levels of vision disorders was compared using Wilcoxon rank sum and Kruskal-Wallis tests. Testability and stereoacuity levels were determined for children without VIP Study–targeted disorders overall and by age. Results Children with VIP Study–targeted vision disorders had significantly worse median stereoacuity than that of children without vision disorders (120 vs. 60 seconds of arc, p < 0.001). Children with the most severe vision disorders had worse stereoacuity than that of children with milder disorders (median 480 vs. 120 seconds of arc, p < 0.001). Among children without vision disorders, testability was 99.6% overall, increasing with age to 100% for 5-year-olds (p = 0.002). Most of the children without vision disorders (88%) had stereoacuity at the two best disparities (60 or 120 seconds of arc); the percentage increasing with age (82% for 3-, 89% for 4-, and 92% for 5-year-olds; p < 0.001). Conclusions The presence of any VIP Study–targeted vision disorder was associated with significantly worse stereoacuity in preschool children. Severe vision disorders were more likely associated with poorer stereopsis than milder or no vision disorders. Testability was excellent at all ages. These results support the validity of the Stereo Smile II for assessing random-dot stereoacuity in preschool children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stereoacuity of Preschool Children with and without Vision Disorders

Ciner¹,

Ying²,

Kulp³

et al. 2014

Optometry and Vision Science

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“…High testability in non-cycloplegic cohorts was thus reported in several centres using the hand-held Retinomax autorefractometer (Nikon Inc, Tokyo, Japan), and positive findings were subsequently evaluated against cycloplegic paediatric ophthalmic examinations. [10][11][12][13][14][15][16][17][18] Between the ages of 2 and 4 years, the testability of single devices increased from about 50 to 90%; however, some conditions remain undetected. The Retinomax can identify significant ametropia immediately but poor cooperation from the child should further direct attention to deviations from normal.…”

Section: Introductionmentioning

confidence: 99%

The usefulness of the Retinomax autorefractor for childhood screening validated against a Danish preterm cohort examined at the age of 4 years

Fledelius

Bangsgaard

Slidsborg

et al. 2015

Eye

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Background and purpose Refractometers have gained a foothold in childhood screening for ophthalmic disorders. Given the results of an ophthalmic follow-up of an extremely preterm Danish cohort, the results of the Retinomax autorefractor were further evaluated. Materials and methods A nationwide cohort of infants born before gestational age 28 weeks (n = 178) and 56 term controls were examined at the age of 4 years. Refraction was given as the cycloplegic Retinomax value. For this study, we analysed the equipment's confidence value on the printout and equipment-induced myopization (as the difference between refraction measured before and after topical cyclopentholate 1%), both items hypothetical with a view to having identified factual ophthalmic deviations. Results Thirty-two of 42 eyes with visual acuity ≤ 0.4 had high Retinomax confidence values (8-9); the Retinomax values were also high in 10 of 12 children with strabismus and lack of stereopsis. Low values (1-6) were recorded in 11 single eyes, 5 of which were normal (false positives). Three children already known to have low vision were unable to cooperate. The overall mean value for equipment-induced myopization was 1.9 D (range, 0-6.87 D). Myopization showed no correlation with visual acuity and corneal curvature, and a weak positive correlation with refractive value disappeared when the myopic outliers were excluded. Conclusions The hand-held Retinomax seemed to be reliable for assessing refraction in 4-year-old children, provided a cycloplegic

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“…However, an objective instrument that would accurately measure refractive error in infants and toddlers without cycloplegia would be of great value. While traditional tabletop autorefractors are generally not suitable because of their stationary design and their close working distance, 1,2 there has been some success in estimating refractive error in infants and young children using handheld instruments. 2–37 Measurements in children without cycloplegia often show “instrument myopia,” that is, an underestimation of hyperopia or overestimation of myopia because of accommodation.…”

mentioning

confidence: 99%

“…While traditional tabletop autorefractors are generally not suitable because of their stationary design and their close working distance, 1,2 there has been some success in estimating refractive error in infants and young children using handheld instruments. 2–37 Measurements in children without cycloplegia often show “instrument myopia,” that is, an underestimation of hyperopia or overestimation of myopia because of accommodation. 6,9,10,14,16,25,29–32,38,39 Instrument designers have attempted to deal with this issue by using “non-accommodative” fixation targets, by incorporating a fogging mechanism, or by using a correction factor in estimation of spherical refractive error.…”

mentioning

confidence: 99%

Utility of an open field Shack-Hartmann aberrometer for measurement of refractive error in infants and young children

Harvey

Miller

Schwiegerling

2013

Journal of American Association for Pediatric Ophthalmology and

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PURPOSE To assess the utility of an open-field Shack-Hartmann aberrometer for measurement of refractive error without cycloplegia in infants and young children. METHOD Data included 2698 subject encounters with Native American infants and children aged 6 months to <8 years. We attempted right eye measurements without cycloplegia using the pediatric wavefront evaluator (PeWE) on all participants while they viewed near (50 cm) and distant (2 m) fixation targets. Cycloplegic autorefraction (Rmax [Nikon Retinomax K-plus2]) measurements were obtained for children aged ≥3 years. RESULTS The success rates of noncycloplegic PeWE measurement for near (70%) and distant targets (56%) significantly improved with age. Significant differences in mean spherical equivalent (M) across near versus distant fixation target conditions were consistent with the difference in accommodative demand. Differences in astigmatism measurements for near versus distant target conditions were not clinically significant. Noncycloplegic PeWE and cycloplegic Rmax measurements of M and astigmatism were strongly correlated. Mean noncycloplegic PeWE M was significantly more myopic or less hyperopic and astigmatism measurements tended to be greater in magnitude compared with cycloplegic Rmax. CONCLUSIONS The PeWE tended to overestimate myopia and underestimate hyperopia when cycloplegia was not used. The PeWE is useful for measuring accommodation and astigmatism.

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Testability of refraction, stereopsis, and other ocular measures in preschool children: The Sydney Paediatric Eye Disease Study

Cited by 27 publications

References 31 publications

Stereoacuity of Preschool Children with and without Vision Disorders

Stereoacuity of Preschool Children with and without Vision Disorders

The usefulness of the Retinomax autorefractor for childhood screening validated against a Danish preterm cohort examined at the age of 4 years

Utility of an open field Shack-Hartmann aberrometer for measurement of refractive error in infants and young children

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