Comparison of refractive examination results in children with and without cycloplegia using retinoscopy and autorefractors
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Published on: September 16, 2025
Delvi Indera Mayasari1, Ulfah Rimayanti1,2, Marlyanti Nur Rahmah3
1Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Context:
Uncorrected refractive errors are the most common cause of visual impairment and global blindness.
Aims:
This study aims to assess the accuracy of refractive error measurements using streak retinoscopy and autorefraction, both with and without administering cycloplegics, in children aged 4-10 years.
Settings And Design:
This study is an analytical observational research with a cross-sectional design.
Subjects And Methods:
This study was conducted at an eye clinic from January 2020 to August 2020, with 90 subjects. The examination utilized 1% cyclopentolate cycloplegia administered twice within 1 h, along with retinoscopy and autorefractors.
Statistical Analysis Used:
The data were analyzed using the Wilcoxon signed-rank test.
Results:
The study results indicate that (1) there was no significant difference in the mean spherical equivalent (SE) before cycloplegia between the two instruments (P = 0.630); (2) a significant difference in mean SE after cycloplegia was observed for both instruments (P < 0.001); (3) significant differences in mean SE after cycloplegia were noted for both instruments in cases of compound myopic astigmatism (P < 0.001), compound hyperopic astigmatism (P = 0.007), and mixed astigmatism (P = 0.001); and (4) examination of all subjects showed undercorrection of autorefractometry results compared to those of retinoscopy.
Conclusions:
Retinoscopy and autorefractors yield different results for refractive error correction after cycloplegia. Therefore, autorefractor examination with cycloplegia cannot be considered a substitute for retinoscopy with cycloplegia.
