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Screening for refractive errors in 6-9 month old infants by photorefraction
Insights
Photorefraction is a reliable method for infant vision screening. This study found it effective in detecting hypermetropia, myopia, and anisometropia in infants aged 6-9 months.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Refractive errors in infants can impact visual development.
- Early detection of refractive errors is crucial for preventing long-term visual impairment and strabismus.
Purpose of the Study:
- To evaluate the validity and practicality of isotropic photorefraction for refractive screening in infants.
- To determine the prevalence of refractive errors in a cohort of 6-9 month old infants.
- To assess the reliability of photorefraction compared to retinoscopy.
Main Methods:
- Isotropic photorefraction was employed for screening 1096 infants aged 6-9 months under cyclopentolate cycloplegia.
- Photorefraction measurements were calibrated against retinoscopic examinations.
- Follow-up retinoscopy was conducted to confirm identified refractive errors.
Main Results:
- Prevalence rates: 5% hypermetropia (>+3.5 D), 4.5% myopia, and 1.3% anisometropia (>1 D).
- Retinoscopic follow-up confirmed most diagnosed refractive errors.
- Photorefraction missed one small refractive error in 52 infants (approximately 4.7%).
Conclusions:
- Isotropic photorefraction is a valid and practical technique for infant refractive screening.
- Early detection of refractive errors via photorefraction holds potential for strabismus prediction and prevention.
- Further longitudinal studies are needed to assess the long-term benefits of early detection.
Abstract:
The method of isotropic photorefraction has been used in a trial of refractive screening of 6-9 month old infants. Data are presented on the calibration of the method against retinoscopic measurements and its reliability. In photorefractive screening of 1096 infants under cyclopentolate cycloplegia 5% were found to be hypermetropic (over +3.5 D), 4.5% myopic, and 1.3% anisometropic (over 1 D). These refractive errors were confirmed on retinoscopic follow-up (with the exception of a few anisometropes). Follow-up of controls shows that one small refractive error was missed in 52 infants. We conclude that photorefraction is a valid and practical screening technique. Longitudinal study of infants with refractive errors will assess the value of early detection, in particular for prediction and prevention of strabismus.