Agreement Between Retinoscopy, Autorefractometry and Subjective Refraction for Determining Refractive Errors in Congolese Children

Mukash, Sabrina N; Kayembe, D. L.; Mwanza, Jean-Claude

doi:10.2147/opto.s303286

Cited by 11 publications

(10 citation statements)

References 36 publications

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“…Several studies on children have shown that lack of cycloplegia is associated with a slight overestimation of myopia and marked errors in estimates of the prevalence of emmetropia and hyperopia [5]. In clinical practice, cycloplegic autorefraction and retinoscopy are recommended for children [17][18][19]. Consequently, we first compared BWFOM refraction with autorefraction and retinoscopy under cycloplegia to determine its accuracy for children's refraction.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of objective and subjective refraction with and without cycloplegia using binocular wavefront optometer with autorefraction and retinoscopy in school-age children

Lei

Chen

Cheng

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To compare school-age children’s objective and subjective refraction using a binocular wavefront optometer (BWFOM) with autorefraction and retinoscopy before and after cycloplegia. Methods Eighty-six eyes from 86 children (6–15 years old) were enrolled in this cross-sectional study. BWFOM objective and subjective refractions were compared with autorefraction and retinoscopy under cycloplegia. BWFOM refraction was evaluated before and after cycloplegia. Measurements were compared using a paired t-test; agreement was assessed using Bland–Altman plots. Results Under cycloplegia, the sphere, spherical equivalence, and J45 were significantly more negative on BWFOM objective refraction than autorefraction (− 1.39 ± 2.20 D vs. − 1.28 ± 2.23 D, P = 0.003; − 1.84 ± 2.38 D vs. − 1.72 ± 2.43 D, P = 0.001; − 0.02 ± 0.17 D vs. 0.03 ± 0.21 D, P = 0.004). The subjective sphere of BWFOM was less myopic, and the cylinder and the J45 were more negative than those with retinoscopy (− 1.17 ± 2.09 D vs. − 1.25 ± 2.20 D, P = 0.02; − 0.91 ± 0.92 D vs. − 0.76 ± 0.92 D, P < 0.001; − 0.01 ± 0.15 D vs. 0.03 ± 0.21 D, P = 0.028). For both BWFOM objective and subjective refraction, sphere and spherical equivalence with noncycloplegia were more myopic than those with cycloplegia (objective: − 1.76 ± 2.10 D vs. − 1.39 ± 2.20 D, − 2.21 ± 2.30 D vs. − 1.84 ± 2.38 D, P < 0.001; subjective: − 1.57 ± 1.92 D vs. − 1.17 ± 2.09 D, − 2.01 ± 2.13 D vs. − 1.62 ± 2.27 D, P < 0.001). Bland–Altman plots showed good agreement in spherical equivalence between BWFOM objective refraction and autorefraction (mean difference = 0.12 D, 95% confidence interval [CI] − 0.52 to 0.76), subjective refraction with retinoscopy (mean difference = − 0.01 D, 95% CI − 0.65 to 0.64), and BWFOM refractions with or without cycloplegia (objective: mean difference = − 0.37 D, 95% CI − 1.31 to 0.57; subjective: mean difference = − 0.39 D, 95% CI − 1.30 to 0.51). The time cost by BWFOM was significantly less than the total time of autorefraction and retinoscopy (264.88 ± 90.67 s vs. 315.89 ± 95.31 s, P < 0.001). Conclusion BWFOM is a new device that realizes both objective and subjective refraction. For children’s refractive errors, it is more convenient and quicker to obtain the proper prescription at a 0.05-D interval, and it is more accurate than autorefraction and retinoscopy under cycloplegia.

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Section: Discussionmentioning

confidence: 99%

Comparisons of objective and subjective refraction with and without cycloplegia using binocular wavefront optometer with autorefraction and retinoscopy in school-age children

Lei

Chen

Cheng

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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“…This study was limited by the impossibility of using cycloplegics in screenings during objective refraction, adopting static refraction with the use of a Keeller Professional Streak Retinoscope and subjective refraction to avoid overestimating the prevalence of myopia. Studies have shown that non-cycloplegic retinoscopy and subjective refraction are clinically accurate and can be applied to screening for refractive error in children, showing good agreement with cycloplegic refraction [45,46]. Furthermore, due to the difficulty of performing repeated measurements among children during the program, due to the limited time of the program, a reliability study using intra-and inter-observer measures was not performed…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Visual Impairment and Refractive Errors among a Youth Population in Mozambique: Evidence of the Need for Intervention

et al. 2021

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Visual impairment (VI) can significantly interfere in the child’s daily activities and quality of life, having a negative effect on their development and learning. The aim of the study was to determine the prevalence of VI and associated demographic factors in students examined during the program “Moçambique te vejo melhor”. This study was cross-sectional and retrospective, based on the 2018/19 edition of the program. Eye examinations were performed in secondary school students, aged between 12 and 20 years, of five districts in Nampula province. The examination included visual acuity, non-cycloplegic refraction and assessment of the anterior and posterior segment and ocular adnexa. The prevalence of uncorrected, presenting and best-corrected VI found was 18.3%, 10.8%, and 5.0%, respectively. Refractive error (RE) had a prevalence of 24.7%, and the age groups between 15–17 years and 18–20 years were significantly associated with myopia (with OR: 4.9 and OR: 8.8, respectively), as well as the 11th and 12th grade (OR: 8.1 and OR: 10.7, respectively), and Malema district had association with myopia (ORa: 0.4) and hyperopia (ORa: 0.4 and OR: 0.3) as a protective factor. The prevalence of RE and VI was relatively high, showing the need for greater intervention at the school level.

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“…It is crucial to accurately measure refractive status in children as overestimation or underestimation of error causes accommodative stress, which increases the risk of amblyopia (Lei et al, 2023). Several methods, such as photorefraction, autorefractometry, retinoscopy, and subjective refraction, are used to measure refractive errors (Mukash et al, 2021). Both auto refractometry and retinoscopy are reliable techniques for assessment of refractive errors.…”

Section: Introductionmentioning

confidence: 99%

“…There may be discrepancies among the final objective corrective achieved with retinoscopy, autorefraction (AR), and subjective refraction accepted by the patient. The previous studies are inconclusive regarding determining the most accurate technique for subjective correction (Kedia and Baruah, 2022;Magome et al, 2021;Mukash et al, 2021). These discrepancies can be due to various factors such as the age of the patients, differences in autorefractors, the experience of the operator performing retinoscopy, and cycloplegic use (Mohana Priya et al).…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Autorefraction and Retinoscopy for Subjective Correction in Children

YAR,

ZAHID,

NAWAB

et al. 2023

Biol Clin Sci Res J

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The study's objective was to compare the accuracy of retinoscopy and autorefraction for subjective correction in children. The study was conducted in the Department of Ophthalmology at Nishtar Medical Hospital from June 2021 to May 2022, and it was a prospective study. The study included 60 children aged between 6 to 15 years who had asthenopic symptoms and blurring of vision. The children were given cyclopentolate 1% eyedrops thrice at intervals of 10 minutes to achieve cycloplegia. After an hour of instilling eye drops, cycloplegic retinoscopy, and autorefractometry were performed. Three values of each technique were recorded, and the average was calculated. After three days, binocular and monocular subjective refraction was performed until the best-corrected visual acuity (BCVA) was achieved. Results showed that 40.8% (49 eyes) were hypermetric, and 50% (60 eyes) were myopic based on subjective refraction. Comparison of spherical error by subjective refraction and retinoscopy showed that myopic eyes had a mean of -1.36 ± .98 and -1.08± .82 on subjective correction and retinoscopy, respectively (P=.07), and hypermetropic eyes had a mean of 2.5± .22 and 2.45± .22 on subjective correction and retinoscopy, respectively (P=0.07). Comparison of spherical error by subjective refraction and autorefractometer showed myopic eyes had a mean value of -1.51 ± 1.3 on autorefraction (P=.0001) while hypermetropic eyes had a mean of 2.39± .37 on autorefraction (P=0.0001). Mean cylindrical error values by retinoscopy were -.0729± .304, and by the subjective method, were -.167± .384 (P =0.0007). Mean cylindrical error values by autorefraction were .207± .487 compared to -.167± .384 by the subjective method (P =0.0088). In conclusion, conventional retinoscopy is the most accurate and reliable method for estimating the refractive status. However, autorefraction also has acceptable accuracy and can be used for cylindrical correction.

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Agreement Between Retinoscopy, Autorefractometry and Subjective Refraction for Determining Refractive Errors in Congolese Children

Cited by 11 publications

References 36 publications

Comparisons of objective and subjective refraction with and without cycloplegia using binocular wavefront optometer with autorefraction and retinoscopy in school-age children

Comparisons of objective and subjective refraction with and without cycloplegia using binocular wavefront optometer with autorefraction and retinoscopy in school-age children

The Prevalence of Visual Impairment and Refractive Errors among a Youth Population in Mozambique: Evidence of the Need for Intervention

Comparison Between Autorefraction and Retinoscopy for Subjective Correction in Children

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