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Accommodative accuracy by retinoscopy versus autorefraction spherical equivalent or horizontal meridian power
Angeline T Nguyen1, Jenna L Wayne1, Ayeswarya Ravikumar1
1Department of Clinical Sciences, University of Houston College of Optometry, Houston, Texas, USA.
This study found good agreement between autorefraction and retinoscopy methods for measuring accommodative lag in children and adults. Using autorefraction power in the 180 meridian provided the narrowest agreement range, even with mild astigmatism.
Area of Science:
- Ophthalmology
- Optometry
- Vision Science
Background:
- Accurate measurement of accommodative lag is crucial for understanding visual function in both pediatric and adult populations.
- Discrepancies between different measurement techniques can impact clinical assessment and research findings.
Purpose of the Study:
- To compare the agreement between monocular estimation method (MEM) retinoscopy and Nott retinoscopy with open-field autorefraction for measuring accommodative lag.
- To evaluate the utility of spherical equivalent versus power in the 180 meridian from autorefraction in assessing accommodative lag across different age groups.
Main Methods:
- The study included 26 children (7-16 years) and 27 adults (22-29 years).
- Accommodative lag was measured using MEM retinoscopy, Nott retinoscopy, and open-field autorefraction at a near target (33 cm).
- Autorefraction data were analyzed for both spherical equivalent and power in the 180 meridian, with statistical analysis including two-factor repeated measures ANOVA.
Main Results:
- No significant difference in mean accommodative lag was found across the techniques (p = 0.48).
- Children exhibited smaller accommodative lags than adults (p < 0.001) and higher amounts of uncorrected astigmatism.
- Mean differences between techniques were small, with the narrowest limits of agreement observed when using autorefraction power in the 180 meridian.
Conclusions:
- Autorefraction and retinoscopic techniques demonstrate good agreement, centered on zero bias, for measuring accommodative lag in both children and adults.
- Calculating autorefraction power in the 180 meridian enhances the agreement range, particularly in individuals with moderate uncorrected astigmatism.
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