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Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
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Study on accommodation by autorefraction and dynamic refraction in children.

Prabhakar Srinivasapur Krishnacharya1

  • 1JSS Medical College, Mysore, Karnataka, India.

Journal of Optometry
|August 19, 2014
PubMed
Summary

Dynamic retinoscopy and autorefractor measurements of accommodative effort in children show comparable accuracy after cycloplegia. This study highlights the importance of cycloplegia for precise refractive error diagnosis in pediatric patients.

Keywords:
Accommodative effortAutorefractionDiopterDynamic retinoscopyauto-refraccióndiópteroesfuerzo acomodativoretinoscopio dinámico

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Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Refractive Error Assessment

Background:

  • Childhood accommodation can complicate accurate diagnosis of latent refractive errors.
  • Dynamic retinoscopy provides precise accommodative response measurements.
  • Autorefractometry can predict accommodative system activation in children.

Purpose of the Study:

  • To investigate the correlation between accommodative effort and dynamic refraction in emmetropic children.
  • To compare the accuracy of autorefractor measurements with dynamic retinoscopy before and after cycloplegia.

Main Methods:

  • A prospective study involving 149 emmetropic children aged 3-16 years.
  • Utilized TOPCON AR RM-8000B autorefractor and dynamic retinoscopy (monocular estimation method).
  • Measurements were taken before and after cycloplegia, using retinoscope mirror light as a target.

Main Results:

  • Mean accommodative effort was -0.63±0.69D and dynamic refraction was -0.07±0.44D before cycloplegia.
  • After cycloplegia, mean accommodative effort was +0.52D.
  • Autorefractor showed -0.17D accommodative effort/dynamic refraction change pre-cycloplegia and +0.90D post-cycloplegia.

Conclusions:

  • TOPCON AR RM-8000B autorefractor performance is comparable to dynamic retinoscopy.
  • Cycloplegia enhances the accuracy and agreement of accommodative measurements.
  • Increased accommodative responses in older children may relate to prolonged near work.