Autorefraction and retinoscopy have equal powers of detection for refractive error

Cycloplegic autorefraction was studied as an alternative to cycloplegic retinoscopy for assessing refractive error in children.

Study design

This US-based retrospective cross-sectional study was conducted in 34 eyes of children aged 3–10 years with unknown refractive error and no ocular pathology. Cycloplegic autorefraction was performed using a tabletop VISUREF 100 machine and cycloplegic retinoscopy was confirmed by an experienced pediatric ophthalmologist. Measurements of cylinder power, sphere power, and axis obtained from both procedures were reviewed.

Outcomes

No statistically significant difference between mean cycloplegic autorefraction and cycloplegic refraction values for cylinder power, sphere power, or axis were identified. Clinically significant different refractions (>0.5 D or >10 degrees) were identified in fewer than 20% of paired (same-eye) refractions for all parameters.

Limitations

The study was retrospective and had a small sample size. The percentage of pediatric patients requiring refraction who could sit for tabletop autorefraction is not known.

Clinical significance

Autorefraction with commonly available tabletop autorefractors could be a reasonable substitute for cycloplegic retinoscopy in cases of uncomplicated refractive error. This could increase access to care for pediatric patients and encourage ophthalmologists who are not comfortable with retinoscopy to treat this segment of the pediatric population. Validation of this study with a larger sample size in a prospective manner would be useful.