Accuracy of noncycloplegic refraction performed at school screening camps

Khurana, Rolli; Tibrewal, Shailja; Ganesh, Suma; Tarkar, Rajoo; Nguyen, Phuong Thi Thanh; Siddiqui, Zeeshan; DasGupta, Shantanu

doi:10.4103/ijo.ijo_982_17

Cited by 10 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another important consideration is the prescription of spectacles for refractive correction by referring the children for cycloplegic refraction to the base hospital in a community screening set up. The attendance rate at the hospital for follow-up cycloplegic refraction is also poor, and there is a poor compliance with referrals [ 16 , 43 ]. These reasons make it essential to look for other solutions to address the problem of cycloplegic refraction in the community.…”

Section: Discussionmentioning

confidence: 99%

“…Cycloplegia is the gold standard to estimate refractive errors among children [ 14 , 15 ], but the use of cycloplegia is restricted and can be done only in the presence of an ophthalmologist in India [ 16 ]. This restriction, the limited resources of both ophthalmologists and optometrists, and the disparity that exists between the available resources and the demand [ 16 , 17 ], present barriers when undertaking large refractive error screening studies in India. Another factor is the difficulty obtaining consent from parents for cycloplegia of their child, possibly due to the side effects associated with cycloplegics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study—Defining a Threshold for Non-Cycloplegic Myopia Prevalence in Children

Gopalakrishnan

Hussaindeen

Sivaraman

et al. 2021

JCM

View full text Add to dashboard Cite

The aim of this study was to investigate the agreement between cycloplegic and non-cycloplegic autorefraction with an open-field auto refractor in a school vision screening set up, and to define a threshold for myopia that agrees with the standard cycloplegic refraction threshold. The study was conducted as part of the Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) study, which investigated the prevalence, incidence, and risk factors for myopia among children in South India. Children from two schools aged 5 to 15 years, with no ocular abnormalities and whose parents gave informed consent for cycloplegic refraction were included in the study. All the children underwent visual acuity assessment (Pocket Vision Screener, Elite school of Optometry, India), followed by non-cycloplegic and cycloplegic (1% tropicamide) open-field autorefraction (Grand Seiko, WAM-5500). A total of 387 children were included in the study, of whom 201 were boys. The mean (SD) age of the children was 12.2 (±2.1) years. Overall, the mean difference between cycloplegic and non-cycloplegic spherical equivalent (SE) open-field autorefraction measures was 0.34 D (limits of agreement (LOA), 1.06 D to −0.38 D). For myopes, the mean difference between cycloplegic and non-cycloplegic SE was 0.13 D (LOA, 0.63D to −0.36D). The prevalence of myopia was 12% (95% CI, 8% to 15%) using the threshold of cycloplegic SE ≤ −0.50 D, and was 14% (95% CI, 11% to 17%) with SE ≤ −0.50 D using non-cycloplegic refraction. When myopia was defined as SE of ≤−0.75 D under non-cycloplegic conditions, there was no difference between cycloplegic and non-cycloplegic open-field autorefraction prevalence estimates (12%; 95% CI, 8% to 15%; p = 1.00). Overall, non-cycloplegic refraction underestimates hyperopia and overestimates myopia; but for subjects with myopia, this difference is minimal and not clinically significant. A threshold of SE ≤ −0.75 D agrees well for the estimation of myopia prevalence among children when using non-cycloplegic refraction and is comparable with the standard definition of cycloplegic myopic refraction of SE ≤ −0.50 D.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study—Defining a Threshold for Non-Cycloplegic Myopia Prevalence in Children

Gopalakrishnan

Hussaindeen

Sivaraman

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Optometric examination: The standard procedure was as follows: Best corrected and uncorrected visual acuity. Objective refraction: non-cycloplegic retinoscopy (differences of ±0.5D were estimated in the spherical equivalent compared to the non-cycloplegic refraction) [ 16 ]. Subjective refraction.…”

Section: Methodsmentioning

confidence: 99%

“…Objective refraction: non-cycloplegic retinoscopy (differences of ±0.5D were estimated in the spherical equivalent compared to the non-cycloplegic refraction) [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

The Prevalence of Myopia in Children in Spain: An Updated Study in 2020

Álvarez-Peregrina

Martínez-Pérez

Villa-Collar

et al. 2021

IJERPH

View full text Add to dashboard Cite

Background: In recent years, there was a significant increase in myopia incidence worldwide. However, it is still not clear how it affects Spanish children. Since 2016, this research team analyzed myopia prevalence and risk in 9668 children aged between 5 and 7 years. It was shown that the prevalence rates increased from 16.8% in 2016 to 20.4% in 2019. The objective of this study is to update the prevalence rate of myopia in Spain in 2020 and analyze the risk and prevention factors of myopia. Methods: The participants underwent an optometric examination, and a questionnaire on their lifestyle, family history, and geographical origin was carried out. Finally, data were analyzed using the SPSS version 27 program. Results: 1601 children from various Autonomous Communities of Spain were examined. In 2020 the myopia rates did not increase compared to 2019 (p < 0.05), although the number of hyperopes decreased and the number of emmetropes increased. Regarding age, the prevalence of myopia increased progressively over the years (p < 0.001). There was no association between gender and myopia (p > 0.05). There was a link between the time spent in near vision and family history with the prevalence of myopia (p < 0.05). Conclusions: The prevalence of myopia in Spain in children between 5 and 7 years old increased significantly between 2016 and 2020.

show abstract

“…However, cycloplegia is often restricted in screening settings. Hence, noncycloplegic refractions using autorefractors with built-in autofogging mechanisms 7 or retinoscopy with noncycloplegic fogging lenses 8–10 to overcome the effects of accommodation are the only alternative in such situations 10 . Most large-scale studies of the accuracy of noncycloplegic refraction in children have included only autorefraction 11–14 .…”

mentioning

confidence: 99%

Accuracy of Noncycloplegic Refraction for Detecting Refractive Errors in School-aged African Children

Ilechie

Addo²,

Abraham

et al. 2021

Optom Vis Sci

View full text Add to dashboard Cite

SIGNIFICANCE:Cycloplegia is often restricted in screening settings. Previous studies have evaluated noncycloplegic refraction for screening, but their data are not fully applicable to school-aged African children. This article adds to the literature by investigating this in school-aged African children. PURPOSE:The purpose of this study was to evaluate the ability of noncycloplegic autorefraction (NCA) and noncycloplegic retinoscopy (NCR) to detect refractive errors in school-aged African children and quantify differences between noncycloplegic and cycloplegic refraction measures.METHODS: Autorefraction and retinoscopy were performed on 150 children aged 6 to 15 years before and after cyclopentolate cycloplegia. Subjective refraction was performed by the same examiner after cycloplegia. Noncycloplegic and cycloplegic measurements were compared, and the data were assessed with receiver operating characteristic curves and Bland-Altman plots.RESULTS: With the exception of cylindrical vector J 0 (P = .17) and J 45 (P = .08) obtained with NCR, all mean measures of NCA and NCR significantly differed from mean cycloplegic subjective refraction measurements by −0.71 ± 0.67 (P ≤ .001; 95% confidence interval, −2.02 to +0.60) and −0.75 ± 0.68 (P ≤ .001; 95% confidence interval, −2.08 to +0.58), respectively. Mean spherical power between the two tests did not differ (NCA −NCR, mean bias of −0.037 ± 0.675 and 95% limits of agreement of −1.36 to 1.286; P = .51). The sensitivities for detecting any refractive error for NCR and NCA were 86.8 and 82.9%, respectively, and the specificities were 82.0% for NCR and 82.4% for NCA. Performance of both tests was excellent for myopia (area under the curve, >0.90; sensitivity, ≥90%) and similar (P = .13), but the specificities for detecting hyperopia were 78.0% for NCR and 80.0% for NCA.CONCLUSIONS: Noncycloplegic refraction may accurately detect astigmatism and myopia in this population but may elicit higher myopic values and lower hyperopic values than using cycloplegic refraction.

show abstract

Accuracy of noncycloplegic refraction performed at school screening camps

Cited by 10 publications

References 26 publications

The Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study—Defining a Threshold for Non-Cycloplegic Myopia Prevalence in Children

The Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study—Defining a Threshold for Non-Cycloplegic Myopia Prevalence in Children

The Prevalence of Myopia in Children in Spain: An Updated Study in 2020

Accuracy of Noncycloplegic Refraction for Detecting Refractive Errors in School-aged African Children

Contact Info

Product

Resources

About