Cycloplegic autorefraction versus subjective refraction: the Tehran Eye Study

Hashemi, Hassan; Khabazkhoob, Mehdi; Asharlous, Amir; Soroush, Sara; Yekta, Abbasali; Dadbin, Nooshin; Fotouhi, Akbar

doi:10.1136/bjophthalmol-2015-307871

Cited by 72 publications

(72 citation statements)

References 18 publications

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“…Overall, cylinder values with autorefraction are significantly overestimated compared with retinoscopy. In a similar comparative study of cycloplegic values using retinoscopy and autorefraction, cylinder values showed a significant difference 16. There is agreement between these two studies in this regard.…”

Section: Discussionmentioning

confidence: 53%

Overestimation of hyperopia with autorefraction compared with retinoscopy under cycloplegia in school-age children

et al. 2018

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Section: Discussionmentioning

confidence: 53%

Overestimation of hyperopia with autorefraction compared with retinoscopy under cycloplegia in school-age children

et al. 2018

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“…The strengths of this review include rigorous methodological procedures to obtain and pool data from 49 789 children. In addition, all the studies in which myopia measurements were self‐reported or measured without cycloplegia were not included in this review due to inaccuracy of these measurements . Several limitations of the present study should be considered.…”

Section: Discussionmentioning

confidence: 99%

The association between digital screen time and myopia: A systematic review

Lança

Saw

2020

Ophthalmic Physiologic Optic

177

146

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Purpose Digital screen time has been cited as a potential modifiable environmental risk factor that can increase myopia risk. However, associations between screen time and myopia have not been consistently reported. Although myopia prevalence increased before the massive use of digital devices in some countries, with the rise being influenced by education, there may be an added recent effect of screen time. The aim of this systematic review is to determine the association between screen time and the risk of developing (1) prevalent or incident myopia, or (2) the risk of myopia progression in children. Published manuscripts were identified in PubMed, ScienceDirect and the Cochrane Library, and citation lists were reviewed. Recent findings Fifteen studies were included (nine cross‐sectional and six cohort studies) with a total of 49 789 children aged between 3 and 19 years old. Seven studies found an association between screen time and myopia. The results showed mixed evidence with the more recent studies exposing a trend of association between hours spent by children using screens and myopia. Meta‐analysis using a random‐effects model was performed in five studies (n = 20 889) that reported odds ratio (OR). The I2 statistics was used to assess heterogeneity. A pooled OR of 1.02 (95% CI: 0.96–1.08; p = 0.48) suggests that screen time is not associated with prevalent and incident myopia in this group of five studies. Summary The results for screen time and myopia are mixed. Further studies with objective screen time measurements are necessary to assess evidence of an association between screen time and myopia.

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“…[9][10][11][12] Previous studies evaluating the difference between cycloplegic and non-cycloplegic measurement of refractive error have focused on the use of autorefraction measures in the context of epidemiological classification of refractive error or compared refractive measurement techniques and/or cycloplegic regimes. 1,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Outcomes from epidemiological studies using autorefraction for categorisation purposes are not relevant in the context of using retinoscopy to establish refractive error, either as a basis for undertaking a subjective refraction and/or for prescribing spectacles.…”

Section: Introductionmentioning

confidence: 99%

Comparison of retinoscopy results with and without 1% cyclopentolate in school‐aged children

Doherty

Doyle

McCullough

et al. 2019

Ophthalmic Physiologic Optic

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Purpose This study was designed with the aim of providing practitioners with an evidence base to inform their clinical decision making as to when cycloplegic retinoscopy is necessary and when it might be appropriate to forgo. The study aimed to determine the age at which there ceases to be a clinically significant difference between cycloplegic and non‐cycloplegic retinoscopy and whether age, refractive error, habitual spectacle wear and accommodation influence the relationship. Methods A single examiner carried out cycloplegic and non‐cycloplegic retinoscopy on 128 children stratified into four age groups (6–7, 8–9, 10–12 and 12–13 years). Cycloplegia was achieved using 1% cyclopentolate and retinoscopy carried out after 30 min. The examiner was masked to the lenses used and to habitual spectacle wear. Accommodation was assessed using dynamic retinoscopy prior to cycloplegia. Results Cycloplegic and non‐cycloplegic sphere differed significantly (z = −9.18, p < 0.0001). Although the difference decreased significantly as age increased (χ2 = 16.57, p = 0.0009), cycloplegic retinoscopy revealed more hyperopia than non‐cycloplegic retinoscopy in all age groups (p < 0.0001). The difference between cycloplegic and non‐cycloplegic results was greater where ‘high’ hyperopia (≥+2.50DS) was present (F1,6 = 12.86, p = 0.0005), and as hyperopia increased the difference increased (Spearman's ρ = 0.55, p < 0.0001). Neither spectacle wear (p = 0.74) nor accommodation (p = 0.08) influenced the difference between spherical measures. Measures of astigmatic error did not differ significantly (z = −1.59, p = 0.11). A non‐cycloplegic sphere ≥+1.50DS was relatively sensitive (87%) and specific (96%) at indicating clinically significant hyperopia (≥+2.50D) as revealed by cycloplegic retinoscopy. Conclusions Cyclopentolate 1% does not impact the cylindrical component of the retinoscopy result, but reveals significantly more hyperopia in the spherical component, both statistically and clinically in children aged 6–13 years. Differences between cycloplegic and non‐cycloplegic sphere increase significantly with increasing hyperopia, independent of spectacle wear and accommodation. A non‐cycloplegic retinoscopy result of ≥+1.50DS may be used by practitioners wishing to identify children aged 6–13 years at risk of clinically significant hyperopia (≥+2.50DS), but cycloplegia is required to accurately ascertain the full spherical error.

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Cycloplegic autorefraction versus subjective refraction: the Tehran Eye Study

Cited by 72 publications

References 18 publications

Overestimation of hyperopia with autorefraction compared with retinoscopy under cycloplegia in school-age children

Overestimation of hyperopia with autorefraction compared with retinoscopy under cycloplegia in school-age children

The association between digital screen time and myopia: A systematic review

Comparison of retinoscopy results with and without 1% cyclopentolate in school‐aged children

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