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A comparison of cycloplegic refraction to the near retinoscopy technique for refractive error determination
M D Wesson1, K R Mann, N W Bray
1University of Alabama, Department of Optometry, School of Optometry/Medical Center, Birmingham 35294.
Insights
Near retinoscopy differs significantly from cycloplegic refraction in determining refractive error for infants and children. Caution is advised when using near retinoscopy as a substitute for cycloplegic refraction, especially in younger children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Refractive error assessment is crucial for pediatric eye care.
- Cycloplegic refraction is the gold standard for accurate refractive error determination in children.
- Near retinoscopy is a potential alternative, but its accuracy compared to cycloplegic refraction requires validation.
Purpose of the Study:
- To compare the accuracy of near retinoscopy with cycloplegic refraction in infants and children.
- To evaluate the influence of age on the differences between the two refractive techniques.
Main Methods:
- A comparative study involving 10 infants (3-12 months) and 10 children (32-109 months).
- Refractive error was determined using both near retinoscopy and standard cycloplegic refraction.
- Sphere and cylinder power measurements were analyzed for significant differences.
Main Results:
- Significant differences were observed between near retinoscopy and cycloplegic refraction for both sphere and cylinder power.
- The discrepancy between techniques tended to be larger in infants compared to older children.
- No significant differences were found based on monocular/binocular conditions, gender, or laterality.
Conclusions:
- Near retinoscopy is not a reliable substitute for cycloplegic refraction in pediatric populations.
- Age is a factor, with greater discrepancies noted in infants.
- Clinical application of near retinoscopy requires careful consideration due to observed differences from the gold standard.
Abstract:
The near retinoscopy technique of refractive error determination was compared to the standard method of cycloplegic refraction using 10 "infants" (3-12 months of age) and 10 "children" (32-109 months of age). There was a significant difference between the techniques for both sphere and cylinder power. Although there was no interaction of refractive technique and age group, the difference between near retinoscopy and cycloplegic refractive error tended to be larger for infants than for children. No significant difference was found when the average refractive values were compared for monocular or binocular conditions and no significant effect was found for either gender or laterality (right versus left eye). Based on these findings, it is suggested that caution be used in substituting the near retinoscopy technique for cycloplegic refraction even utilizing a "correction" factor for the dioptric difference between techniques.
