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Is the Sphere Value Measured by an Autorefractor Reliable in Children under Cycloplegia? Comparison with Streak
Insights
Cycloplegic refraction in children using automated refractors (AKW) yielded higher sphere values than streak retinoscopy (RR). A +0.67 discount is recommended for AKW sphere values in pediatric eye exams.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Refractive Error Assessment
Background:
- Accurate refractive error measurement is crucial for pediatric eye care.
- Cycloplegia is essential for reliable refraction in children.
- Comparing automated refractors with retinoscopy aids in selecting optimal diagnostic tools.
Purpose of the Study:
- To compare cycloplegic refraction measurements between automated refraction and streak retinoscopy in children.
- To assess the reliability and consistency of automated refractors in pediatric populations.
Main Methods:
- A cross-sectional study involving 560 children aged 3-10 years.
- Cycloplegic refraction performed using a table-mounted autorefractor (Kowa KW-2000) and streak retinoscopy.
- Data analysis employed Fourier decomposition of the power profile.
Main Results:
- Automated cycloplegic refraction (AKW) provided more positive M component and sphere values compared to streak retinoscopy (RR).
- AKW showed a trend towards more negative J45 and more positive J0 values, though not statistically significant.
- The Kowa KW-2000 autorefractor demonstrated applicability for cycloplegic refraction in young children.
Conclusions:
- The Kowa KW-2000 autorefractor is suitable for pediatric cycloplegic refraction.
- A specific discount of +0.67 should be applied to sphere values obtained from this autorefractor.
- Careful evaluation of sphere and spherical equivalent values is advised when using automated devices in pediatric populations.
Purpose:
To compare and repeatedly measure cycloplegic refraction in a cross-section of children using retinoscopy and automated refraction.
Methods:
A total of 560 children (corresponding to 1120 eyes) ranging in age from 3 to 10 years participated in the study. Each child underwent a comprehensive eye examination, which included table mounted autorefractor evaluation (Kowa KW-2000) and streak retinoscopy, both after cycloplegia with 1% cyclopentolate hydrochloride. Data were analyzed using Fourier decomposition of the power profile.
Results:
More positive values of M component and sphere value were given by cycloplegic autorefraction (AKW) compared with cycloplegic streak retinoscopy (RR). More negative values for the J45 vector and more positive for J0 were given AKW although this difference was not statistically significant.
Conclusions:
Our study shows that the table mounted autorefkeratometer Kowa KW- 2000 can be applied to young children with cycloplegia as instrument for cycloplegic refraction, and a discount of +0.67 should be applied on the sphere value. Similar care should be taken on the evaluation of the sphere and spherical equivalent values should be applied in other devices.
