| Comparison of Manifest Refraction and Cycloplegic Refraction Using Retinoscopy or an Autorefractor in Children. |
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Aram Park, Seung Ah Chung |
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Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. mingming8@naver.com |
| 소아에서 망막검영법과 자동굴절검사로 시행한 현성굴절검사와 조절마비굴절검사의 비교 |
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박아람⋅정승아 |
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아주대학교 의과대학 안과학교실 |
Correspondence:
Seung Ah Chung,
Email: mingming8@naver.com
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Received: 7 April 2016 • Revised: 6 June 2016 • Accepted: 7 July 2016 |
| Abstract |
PURPOSE
To compare the measurements between manifest refraction and cycloplegic refraction using retinoscopy or an autorefractor in children and to investigate factors affecting the difference. METHODS: A total of 388 children with a mean age of 7.4 ± 3.6 years were examined using retinoscopy and a Grand Seiko GR-3500KA autorefractor before and after cycloplegia. We compared the difference in spherical and cylindrical components between refractions and analyzed the results according to gender, age, type of refractive error, amblyopia, strabismus, and neuro-developmental disorder. A difference in refractions of ±0.50 D or more was considered as a significant discrepancy. RESULTS: Before cycloplegia, the spherical portion of the refractive error via autorefractor measurement was more myopic than for the retinoscopic measurement in 47.2% of patients, and the cylindrical portion was greater in 37.1%. The spherical discrepancies were more common in children aged < 7 years, with hyperopia, or amblyopia (respectively, p = 0.002, p < 0.001, and p = 0.033). After cycloplegia, the spherical component of the refractive error by auto-refraction differed from retinoscopic measurement in 29.4% of patients, and the cylindrical portion differed in 30.7%. However, the difference was not significant and there was no difference according to clinical features. More than half of the children with discrepancies in the spherical component between retinoscopic refractions before and after cycloplegia had a discrepancy between auto-refraction and retinoscopic refraction before cycloplegia, and the two discrepancies had a significant correlation. CONCLUSIONS: Auto-refraction after cycloplegia can estimate retinoscopic values partially. Nevertheless, 30% of the children still showed a discrepancy. The discrepancy of manifest refraction or auto-refraction compared to retinoscopic refraction with cycloplegia should be considered in younger children, cases with hyperopia or amblyopia, and cases with a difference in auto-refraction and retinoscopic refraction before cycloplegia. |
| Key Words:
Auto-refraction;Cycloplegic refraction;Discrepancy;Manifest refraction;Retinoscopic refraction |
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