[Accuracy of two autorefractors--Pediatric Autorefractor plusoptiX and Retinomax--in cycloplegic children in comparison to retinoscopy].

HISTORY: In children, measuring refraction is of interest particularly with regard to the risk of amblyopia. Cycloplegic retinoscopy is the gold standard method for this age group. In a prospective study we compared readings from two hand-held photorefractors, the Pediatric Autorefractor and the Retinomax, to those from retinoscopy. PATIENTS AND METHODS: 74 patients were recruited consecutively at the outpatient department of Heidelberg University Eye Hospital's Section for Strabismology and Neuroophthalmology. All patients underwent standardised cycloplegia measurements first by the Pediatric Autorefractor plusoptiX A 08 in 1 metre working distance, then adding an infrared filter to reduce interferences, followed by the Retinomax K-plus 3 in 5 cm working distance and retinoscopy as reference on the right eye.
RESULTS: Spherical equivalents measured by the Pediatric Autorefractor plusoptiX A 08 coincided in 51.2% with retinoscopy (± 0.5 D). Adding an infrared filter increased this to 60.0%. However, the success rate of measurement decreased to 47% on adding an infrared filter as compared to 55.4% in cycloplegia alone. Children showed no cooperation in 11% and 16% with the infrared filter, respectively. The remaining children were not measurable by means of the device. With regard to spherical equivalents, the measurements done with Retinomax K-plus 3 coincide in 57% with those done in retinoscopy. The success rate of measurements with the Retinomax was 91%. The remaining children showed no cooperation.
CONCLUSION: Retinoscopy in cycloplegia is still the method of choice when determining refraction in children. Autorefractors quickly provide results for comparison which coincide with retinoscopy in 50-60% in spherical equivalent and in 80-90% in cylindrical values. The Pediatric Autorefractor is not suited for everyday clinical routine due to a low success rate of 50% and tight measuring range of + 5.0 to -7.0 D in spherical equivalents. © Georg Thieme Verlag KG Stuttgart · New York.