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Comparison of the Retinomax autorefractor with hand-held retinoscopy in 1-year-old infants
Glen A Gole1, Philip J Schluter, Julie Hall
1Community Child Health Service, Royal Children's Hospital, Brisbane, Queensland, Australia. g.gole@uq.edu.au
Insights
The Retinomax hand-held autorefractor shows good accuracy for infant vision screening, but cooperation is key. Results suggest it
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Medical Device Evaluation
Background:
- Accurate refractive error assessment in infants is crucial for early detection of visual impairments.
- Hand-held autorefractors offer potential for efficient screening in community settings.
- Comparison of new autorefractor technology with established methods is needed.
Purpose of the Study:
- To evaluate the accuracy and usability of the Retinomax hand-held autorefractor.
- To compare Retinomax measurements with hand-held retinoscopy (HHR) in 1-year-old children.
- To assess the impact of patient cooperation on measurement accuracy.
Main Methods:
- Method comparison study involving 327 infants (46-81 weeks).
- Refractive error measured using Retinomax and streak retinoscopy (HHR) under cycloplegia.
- Sphere, cylinder, axis, and spherical equivalent data were recorded and compared.
Main Results:
- Generally close agreement between Retinomax and HHR for refractive error measurements.
- Retinomax readings were consistently ~0.3 D less hyperopic than HHR.
- Significantly more girls struggled with the Retinomax examination than boys (P < 0.001).
- Agreement between instruments decreased when patients struggled during examination (P < 0.001).
Conclusions:
- The Retinomax appears to be a useful screening instrument for early childhood vision.
- Patient cooperation significantly influences the accuracy of Retinomax measurements.
- Careful consideration of usability and cooperation is necessary for adopting this screening tool.
Abstract:
This study aimed to determine the accuracy (and usability) of the Retinomax, a hand-held autorefractor, compared to measurements taken from hand-held retinoscopy (HHR) in a sample of normal 1-year-old children. The study was a method comparison set at four Community Child Health Clinics. Infants (n = 2079) of approximately 1 year of age were identified from birth/immunization records and their caregivers were contacted by mail. A total of 327 infants ranging in age from 46 weeks to 81 weeks (mean 61 weeks) participated in the study. The children underwent a full ophthalmic examination. Under cycloplegia, refraction was measured in each eye by streak retinoscopy (HHR) and then re-measured using the Retinomax autorefractor. Sphere, cylinder, axis of cylinder and spherical equivalent measurements were recorded for HHR and Retinomax instruments, and compared. Across the range of refractive errors measured, there was generally close agreement between the two examination methods, although the Retinomax consistently read around 0.3 D less hyperopic than HHR. Significantly more girls (72 infants, 47.7%), struggled during examination with the Retinomax than boys (52 infants, 29.5%) (P < 0.001). Agreement deteriorated between the two instruments if the patient struggled during the examination (P < 0.001). In general, the Retinomax would appear to be a useful screening instrument in early childhood. However, patient cooperation affects the accuracy of results and is an important consideration in determining whether this screening instrument should be adopted for measuring refractive errors in early infancy.
