Journal: 
Author: 
Lowery, J.P.
Joachim, A.
Olson, R.
Peel, J.
Pearce, N.N.
Title: 
LAutorefraction vs. Retinoscopy A comparison of non-cycloplegic measures in a pediatric sample
Abstract: 

"Autorefraction vs. Retinoscopy: A comparison of non-cycloplegic measures in a pediatric sample""""""|||""""""The purpose of this project was to determine the accuracy of the autorefractor compared to retinoscopy under non-cyclo- plegic conditions, such as occur in vision screenings and triage-level eye care clinics. Seventy-five children evaluated during a humanitarian eye care clinic were included in the study. Autorefraction (Nikon Retinomax) and distance retinoscopy measures were taken pre and post-cycloplegia. Spherical equivalent refractive errors were derived for comparison. The mean difference between non-cyclo- plegic autorefraction and cycloplegic retinoscopy was -1.35D OD and -1.15D OS. The mean difference between non- cycloplegic retinoscopy and cycloplegic retinoscopy was -0.47D OD and -0.25D OS. The case specific range of discrepancy from cycloplegic values was up to -6.63D for non-cycloplegic autorefraction and up to -2.50D for non-cycloplegic retinoscopy. Screening sensitivity for hyperopia (2D) was 43% using non-cycloplegic auto-refraction and 67% using non-cycloplegic retinoscopy. This study provides direct evidence that non-cycloplegic autorefraction underestimates hyperopia to a clinically unacceptable degree in children. Retinoscopy, with appropriate fogging technique is much more likely to yield a clinically acceptable measure of hyperopia in children. Guidelines for appropriate use of the autorefractor in pediatric care are also presented."