DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20220986

A study on non-cycloplegic and cycloplegic streak retinoscopy and autorefractometry in children

Puja Kedia, Mamoni Baruah

Abstract


Background: Refractive errors in children should be identified and corrected as early as possible to prevent irreversible vision loss. Therefore, accurate methods of objective refraction should be employed by paediatric eye care providers when examining young children. The purpose of this study was to assess the accuracy of non-cycloplegic and cycloplegic retinoscopy and autorefractometry as objective methods of refraction, and to determine their suitability with subjective acceptance.

Methods: The one-year study included 453 children of 3-15 years. Noncycloplegic autorefraction and streak retinoscopy were done. These were followed by cycloplegic autorefraction and streak retinoscopy. Cycloplegia was attained by using atropine sulphate 1% eye drops and cyclopentolate hydrochloride 1% eyedrops for children of 3-7 years and 8-15 years respectively. Postmydriatic subjective refraction was then done. Results were compared using Analysis of Variance (ANOVA). Calculated p<0.05 was considered as statistically significant.

Results: Noncycloplegic methods showed underestimation of hypermetropia and overestimation of myopia. The spherical and cylindrical measurements of cycloplegic autorefraction were equivalent to cycloplegic retinoscopy. Axis of cycloplegic autorefraction was better than cycloplegic retinoscopy.

Conclusions: The most accurate method of objective refraction is cycloplegic retinoscopy. However, the spherical and cylindrical measurements of cycloplegic autorefraction can be substituted for conventional cycloplegic retinoscopy in young children.

 


Keywords


Refractive error, Cycloplegia, Autorefraction, Retinoscopy, Subjective refraction

Full Text:

PDF

References


Ovenseri-Ogbomo G, Omuemu V. Prevalence of refractive error among school children in the Cape Coast Municipality, Ghana. Clin Optom. 2010;59.

Akil H, Keskin S, Çavdarli C. Comparison of the Refractive Measurements with Hand-held Autorefractometer, Table-mounted Autorefractometer and Cycloplegic Retinoscopy in Children. Korean J Ophthalmol. 2015;29(3):178.

Clinical Refraction. In: Clinical Optics. American Academy of Ophthalmology. 2018.

Lowery J, Johachim R, Olson R, Peel J, Pearce N. Autorefraction vs. 2005;16(1):3-8.

Deepikadevi S, Sundararajan D, Namitha K, Murali K. Comparing the effect of conventional method of retinoscopic refraction with computerized automated refraction in various refractive error patients. Int Arch Integr Med. IJAM. 2017;4(10):104-10.

Abrams D. Objective methods of refraction. In: Duke-Elder’s Practice of Refraction. 10th ed. India: Butterworth Heinemann Elsevier. 2016;169.

The pediatric eye examination. In: Basic and clinical science course, volume 6,Pediatric ophthalmology and strabismus. American Academy of Ophthalmology. 2018.

Abrams D. Objective methods of refraction. In: Duke-Elder’s Practice of Refraction. 10th ed. India: Butterworth Heinemann Elsevier. 2016;170.

Havener WH. Ocular pharmacology. Second. United States of America: The C.V. Mosby Company. 1970;196.

Bron AJ, Tripathi RC, Tripathi BJ. The cornea and sclera. In: Wolff’s Anatomy of the eye and orbit. 8th ed. Spain: Chapman and Hall Medical. 1997;235-63.

Rotsos T, Grigoriou D, Kokkolaki A, Manios N. A comparison of manifest refractions, cycloplegic refractions and retinoscopy on the RMA-3000 autorefractometer in children aged 3 to 15 years. Clin Ophthalmol. 2009;2009:429-31.

Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children: Results from Shunyi District, China. Am J Ophthalmol. 2000;129(4):427-35.

Funarunart P, Tengtrisorn S, Sangsupawanich P, Siangyai P. Accuracy of noncycloplegic refraction in primary school children in southern Thailand. J Med Assoc Thail. 2009;92(6):806-12.

Pedamallu S, Reddy K, Pedamallu R, Pedamallu C. Reliability of Cycloplegic Autorefractor Measurements to determine Spherical and Astigmatic Refractive Errors in Young Children. Internet J Ophthalmol Vis Sci. 2012;6(1):1-5.

Guha S, Shah S, Shah K, Hurakadli P, Majee D, Gandhi S. A comparison of cycloplegic autorefraction and retinoscopy in Indian children. Clin Exp Optom. 2017;100(1):73-8.

Pokupec R, Mrazovac D, Popović-Suić S, Mrazovac V, Kordić R, Petricek I. Comparison between refractometer and retinoscopy in determining refractive errors in children--false doubt. Coll Antropol 2013;37(Suppl 1):205-8.

Walline J, Kinney K, Zadnik K, Mutti D. Repeatability and validity of astigmatism measurements. J Refract Surg. 1999;15(1):23-31.

Wood MG, Mazow ML, Prager TC. Accuracy of the Nidek ARK-900 objective refractor in comparison with retinoscopy in children ages 3 to 18 years. Am J Ophthalmol. 1998;126(1):100-8.

Jorge J, Queirós A, Almeida JB, Parafita MA. Retinoscopy/autorefraction: Which is the best starting point for a noncycloplegic refraction? Optom Vis Sci. 2005;82(1):64-8.

Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. Parental myopia, Near Work, School Achievement, and Children ’ s Refractive Error. Investig Opthalmology Vis Sci. 2002;43(12):3633-40.