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Accuracy of Photorefraction and Wavefront-Based Autorefraction in Children Under 3 Years of Age

Caner Kara1, Ikbal Seza Petricli1

  • 1Department of Ophthalmology, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.

Beyoglu Eye Journal
|January 10, 2022
PubMed

Insights

Photorefraction and wavefront-based autorefraction underestimate refractive error in young children. Wavefront autorefraction with cycloplegia may be an alternative to cycloplegic retinoscopy for pediatric eye exams.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Vision Science

Background:

  • Accurate refractive error assessment in children under 3 is crucial for early detection and management of visual impairments.
  • Traditional methods like cycloplegic retinoscopy are considered the gold standard but can be challenging in very young children.
  • Non-cycloplegic autorefraction and photorefraction offer potential alternatives for faster screening.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of photorefraction (Spot Vision Screener) and wavefront-based autorefraction (SureSight Vision Screener) compared to cycloplegic retinoscopy in children under 3 years old.
  • To assess the performance of these devices before and after cycloplegia.

Main Methods:

  • A cross-sectional study included 305 children under 3 years with refractive errors.
  • Measurements of spherical equivalent (SE) and Jackson cross-cylinder values were taken using Spot Vision Screener and SureSight Vision Screener, both before and after cycloplegia.
  • Results were compared against cycloplegic retinoscopy.

Main Results:

  • Both devices significantly underestimated SE values before cycloplegia compared to retinoscopy (p<0.001).
  • After cycloplegia, SureSight Vision Screener showed no significant difference compared to retinoscopy (p=0.66).
  • Spot Vision Screener, even after cycloplegia, yielded significantly higher SE values than retinoscopy (p<0.001).

Conclusions:

  • Both photorefraction and autorefraction devices tend to underestimate refractive error in this age group.
  • Wavefront-based autorefraction (SureSight) with cycloplegia shows promise as a viable alternative to cycloplegic retinoscopy for pediatric refractive assessment.
  • Further studies are needed to confirm the utility of wavefront autorefraction in this population.
Abstract

Keywords:
Accuracyamblyopiachildocularrefractionrefractive errorsrefractometry

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