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Updated: Nov 12, 2025
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Prediction of cycloplegic refraction for noninvasive screening of children for refractive error
Kazuyoshi Magome1,2, Naoyuki Morishige1, Akifumi Ueno1
1Ohshima Eye Hospital, Fukuoka, Fukuoka, Japan.
Insights
Accurate refractive error detection in children is vital. New prediction models using ocular biometry estimate refractive error without cycloplegic eyedrops, showing high correlation with measured values.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Refractive Error Research
Background:
- Early detection of refractive error in children is critical to prevent amblyopia and preserve quality of life.
- Accurate refractive error assessment is essential for timely intervention and management.
Purpose of the Study:
- To develop and validate prediction models for spherical and cylinder refractive error in children.
- To assess the efficacy of ocular biometry in predicting cycloplegic refraction without cycloplegic eyedrops.
Main Methods:
- Retrospective study involving 1221 eyes from 617 children, divided into development, validation, and comparison groups.
- Autorefractometry used to determine noncycloplegic and cycloplegic refraction.
- Stepwise multiple regression analysis applied to ocular biometry data to create prediction models.
Main Results:
- Prediction models showed significant correlation with measured cycloplegic spherical (R=0.961) and cylinder refraction (R=0.894) in the validation group.
- Predicted spherical refraction closely matched cycloplegic refraction, unlike noncycloplegic refraction.
- Predicted cylinder refraction showed no significant difference from noncycloplegic or cycloplegic values.
Conclusions:
- Ocular biometry-based prediction models offer reliable estimates of refractive error in children.
- These models provide an alternative to cycloplegic eyedrops for estimating spherical and cylinder refraction.
- The findings support the use of non-invasive methods for refractive error assessment in pediatric populations.
Abstract:
Detection of refractive error in children is crucial to avoid amblyopia and its impact on quality of life. We here performed a retrospective study in order to develop prediction models for spherical and cylinder refraction in children. The enrolled 1221 eyes of 617 children were divided into three groups: the development group (710 eyes of 359 children), the validation group (385 eyes of 194 children), and the comparison group (126 eyes of 64 children). We determined noncycloplegic and cycloplegic refraction values by autorefractometry. In addition, several noncycloplegic parameters were assessed with the use of ocular biometry. On the basis of the information obtained from the development group, we developed prediction models for cycloplegic spherical and cylinder refraction in children with the use of stepwise multiple regression analysis. The prediction formulas were validated by their application to the validation group. The similarity of noncycloplegic and predicted refraction to cycloplegic refraction in individual eyes was evaluated in the comparison group. Application of the developed prediction models for spherical and cylinder refraction to the validation group revealed that predicted refraction was significantly correlated with measured values for cycloplegic spherical refraction (R = 0.961, P < 0.001) or cylinder refraction (R = 0.894, P < 0.001). Comparison of noncycloplegic, cycloplegic, and predicted refraction in the comparison group revealed that cycloplegic spherical refraction did not differ significantly from predicted refraction but was significantly different from noncycloplegic refraction, whereas cycloplegic cylinder refraction did not differ significantly from predicted or noncycloplegic values. Our prediction models based on ocular biometry provide estimates of refraction in children similar to measured cycloplegic spherical and cylinder refraction values without the application of cycloplegic eyedrops.
