Comparison of the techniques of videorefraction and static retinoscopy in the measurement of refractive error in infants.

Photorefraction has been suggested as a suitable method of screening for refractive error in infants. The relative performance of cycloplegic and non-cycloplegic videorefraction and cycloplegic retinoscopy was investigated on 150 infants. Under cycloplegic conditions the correlation between findings for spherical error (Rxy = 0.70) was compatible with a previous study. However, where cycloplegia was not used for videorefraction, there was poor agreement between the two techniques in the case of astigmatic error, and all types of ametropia. Interobserver repeatability was very high both for cycloplegic retinoscopy (Rxy = 0.96 spherical error, and Rxy = 0.75 astigmatic error) and for videorefraction measurements (Rxy = 0.95 horizontal meridian of photograph and Rxy = 0.85 vertical meridian). Intraobserver repeatability was also good, both for cycloplegic retinoscopy (Rxy = 0.91 spherical error and 0.82 astigmatic error) and for videorefraction with regard to spherical errors (Rxy = 0.84). Throughout the experiments videorefraction measurements of astigmatic errors proved less consistent when compared with cycloplegic retinoscopy, and to its internal reliability.