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School bus accommodation-relaxing skiascopy.

Andrew W Arnold1, Stephanie L Arnold1, Jacob H Sprano2

  • 1Pacific Northwest University College of Osteopathic Medicine, Yakima, WA, USA.

Clinical Ophthalmology (Auckland, N.Z.)
|October 22, 2019
PubMed
Summary
This summary is machine-generated.

School bus accommodation-relaxing skiascopy (SBA-RS) accurately estimates hyperopia and astigmatism in children, even those with developmental delays. This method offers a precise, rapid alternative to cycloplegic refraction, reducing the need for eye drops.

Keywords:
cycloplegiahyperopiaretinoscopyskiascopy

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Area of Science:

  • Ophthalmology
  • Pediatric Eye Care
  • Refractive Error Assessment

Background:

  • Accurate refractive error assessment in children, particularly those with developmental delays, presents significant challenges.
  • Conventional skiascopy requires vertical lens insertion, which can be difficult in pediatric patients.
  • The need for cycloplegia (eye drops) can be a barrier in pediatric eye examinations.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of a novel accommodation-relaxing horizontal skiascopy (SBA-RS) technique.
  • To compare SBA-RS with traditional cycloplegic retinoscopy and a handheld autorefractor (Retinomax) in a pediatric population.
  • To determine the efficacy of SBA-RS in estimating hyperopia and astigmatism, especially in children with neurodevelopmental delays.

Main Methods:

  • A diagnostic test evaluation was conducted on 470 pediatric patients undergoing eye examinations.
  • Cycloplegic retinoscopy (using cyclopentolate 1%) was performed and compared to dry SBA-RS and Retinomax measurements.
  • Outcome measures included correlations, Chi-square analysis, and receiver operating characteristic (ROC) curves to assess diagnostic performance.

Main Results:

  • SBA-RS demonstrated high correlation with cycloplegic retinoscopy for spherical equivalent and astigmatic components, with a minimal lag of approximately 0.15D in hyperopic patients.
  • The technique showed high sensitivity (92%) and specificity (94%) in screening for amblyopia risk factors.
  • Measurements were similar between SBA-RS and retinoscopy, even in patients with developmental delays, whereas Retinomax showed greater deviation.

Conclusions:

  • Accommodation-relaxing horizontal skiascopy (SBA-RS) provides a precise estimation of astigmatism power and axis.
  • This method is largely independent of neurodevelopmental delay and offers a rapid alternative to cycloplegic refraction.
  • SBA-RS has the potential to reduce the need for cycloplegia in pediatric eye exams, improving efficiency and patient comfort.