Comparison of photorefraction, autorefractometry and retinoscopy in children

Photorefractive devices have been evaluated for their effectiveness in detecting anisometropia, hyperopia, myopia, and astigmatism. We investigated the reliability of Plusoptix S08, the newest photoscreener, and Topcon autorefractometer by comparing them with cycloplegic retinoscopy. Plusoptix S08, cycloplegic retinoscopy, and cycloplegic autorefractometer measurements for 235 eyes of 118 children (59 female, 59 male) with a mean age of 4.9 ± 2.6 and median age of 5 years (range 1-12) were conducted. The Plusoptix S08 produced the following mean (± SD) results--spherical 0.27 ± 1.64, cylindrical power -0.81 ± 0.71, axis 89.73 ± 61.18, and spherical equivalent -0.05 ± 1.61. The cycloplegic retinoscopy produced the following mean (± SD) results--spherical 0.12 ± 1.35, cylindrical power -0.89 ± 0.71, axis 92.18 ± 68.39, and spherical equivalent -0.15 ± 1.31. The cycloplegic autorefractometer produced the following mean (± SD) results--spherical 0.16 ± 1.44, cylindrical power -0.88 ± 0.72, axis 90.86 ± 68.21, and spherical equivalent -0.12 ± 1.41. This study has shown that cycloplegic autorefractometer and retinoscopy results are similar and Plusoptix S08 is a very safe, easy-to-use and reliable screening method of refraction, especially for ophthalmologists unskilled in retinoscopy. Plusoptix S08 is a useful tool for estimating refraction in patients for whom conventional autorefraction is not an option.