A comparison of photorefraction and retinoscopy in children

J AAPOS. 2007 Dec;11(6):606-11. doi: 10.1016/j.jaapos.2007.04.006. Epub 2007 Jun 25.

Abstract

Purpose: To compare the results of photorefraction measurement obtained with a Plusoptix CR03 to those of cycloplegic retinoscopy as a standard refraction method in children.

Methods: We assessed the refractive status of 204 eyes in 204 healthy children. The values acquired via photorefraction (noncycloplegic refraction) with a Plusoptix CR03 device were compared with those obtained via cycloplegic retinoscopy. Both methods were used in the same eyes and in all children. The paired tt-test and Pearson's correlation analysis were used for statistical analysis.

Results: The mean age was 7.1 +/- 2.4 years (range, 9 months to 14 years). The average spherical refractive error was +0.05 +/- 0.65 D for photorefraction versus +0.75 +/- 0.77 D for cycloplegic retinoscopy (average difference, -0.70 D; p < 0.001), with moderate correlation between measures (r = 0.63). The average cylinder power was +0.43 +/- 0.38 D for photorefraction versus +0.29 +/- 0.38 D for cycloplegic retinoscopy (average difference, +0.14 D; p < 0.001), with moderate correlation between measures (r = 0.70). The average spherical equivalent was +0.26 +/- 0.63 D for photorefraction versus +0.90 +/- 0.76 D for cycloplegic retinoscopy (average difference, -0.64 D; p < 0.001), with moderate correlation between measures (r = 0.63).

Conclusions: The Plusoptix CR03 device tends toward minus overcorrection in children, resulting in overdiagnosis of myopia. Studies of a population of subjects with a larger range of ametropia will be required to validate this instrument as a screening tool.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • False Negative Reactions
  • Female
  • Humans
  • Infant
  • Male
  • Predictive Value of Tests
  • Refraction, Ocular*
  • Refractive Errors / diagnosis*
  • Reproducibility of Results
  • Retinoscopy / methods*
  • Sensitivity and Specificity
  • Vision Screening / instrumentation*