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Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Accuracy of the Retinomax K-plus3 in measuring refractive error in a pediatric population
Michelle Y Peng1, Noelle Matta2, David Silbert2
1Wilmer Eye Institute, Johns Hopkins School of Medicine.
Purpose:
To compare the Retinomax K-plus3 handheld autorefractor to a retinscopically based refraction performed by a pediatric ophthalmologist.
Methods:
The medical records of 311 children aged 5 months to 17 years who underwent cycloplegic refraction by both autorefractor and a pediatric ophthalmologist on the same day were retrospectively reviewed. Spherical equivalent, vector dioptric distance (VDD) values, and t tests were performed for each metric with an accompanying age-group comparison (<5 years, 5-7 years, 8-10 years, and ≥11 years). Bland-Altman plots were generated to evaluate the agreement between methods.
Results:
Overall, the refraction provided by the Retinomax autorefractor was not significantly different in regard to cylinder power and axis. An age-group comparison showed statistically similar readings for all measures of refractive error in children 8-10 years of age. Statistically similar readings were obtained for cylinder power and axis except in children aged 5-7 years. The VDD was statistically different between the two methods for every age group. Bland-Altman plots suggested agreement between the two approaches for the entire cohort with respect to sphere, cylinder, axis, and spherical equivalent.
Conclusions:
In children <18 years of age, there was no clinical difference in the cycloplegic refraction determined by the Retinomax autorefractor when compared to retinoscopy by a pediatric ophthalmologist.
