Measurement Accuracy When Using Spot Vision Screener With or Without Cycloplegia in Young Adults

There are many unclear points about the accuracy of measurement of cycloplegic refraction using the Spot Vision Screener (SVS). This study aimed to investigate the accuracy of SVS measurements with cycloplegia for myopia.

Forty-nine healthy subjects were included, and refraction was measured. Objective refractions were measured by SVS, table-mounted autorefractometer (RT7000), and handheld autorefractometer (Retinomax Screeen) at noncycloplegic and cycloplegic conditions by 1% cyclopentolate. Subjective noncycloplegic refraction was obtained by a visual acuity and refraction test performed by certified orthoptists using a cross-cylinder. One-way repeated-measures analysis of variance was used to examine whether the measured refractions fluctuate due to different reflection tests.

In the noncycloplegic condition, the mean (±standard deviation) spherical equivalent (SE) measured by subjective method, SVS, RT7000, and Retinomax Screeen were -2.56 ± 3.00, -2.62 ± 2.38, -3.05 ± 2.84, and -3.26 ± 2.97, respectively. The subjective SE and objective SE measured by SVS had significantly less myopic value than the objective SE measured by two autorefractometers (p < 0.001). In the cycloplegic condition, the mean (± standard deviation) SE measured by SVS, RT7000, and Retinomax Screeen were -2.07 ± 2.66, -2.62 ± 2.98, and -2.66 ± 3.02, respectively. The objective SE measured by SVS had significantly less myopic value than SEs measured using other methods (p < 0.001). In the cycloplegic condition, SVS showed a fixed error wherein the SE was more hyperopic than that with the subjective method and SVS had a proportional error.

In the measurement under cycloplegic conditions, use of an autorefractometer rather than a photorefractometer such as SVS was preferable.