Comparison of refractive examination results in children with and without cycloplegia using retinoscopy and autorefractors

Abstract

Abstract: CONTEXT: Uncorrected refractive errors are the most common cause of visual impairment and global blindness. AIMS: This study aims to assess the accuracy of refractive error measurements using streak retinoscopy and autorefraction, both with and without administering cycloplegics, in children aged 4–10 years. SETTINGS AND DESIGN: This study is an analytical observational research with a cross-sectional design. SUBJECTS AND METHODS: This study was conducted at an eye clinic from January 2020 to August 2020, with 90 subjects. The examination utilized 1% cyclopentolate cycloplegia administered twice within 1 h, along with retinoscopy and autorefractors. STATISTICAL ANALYSIS USED: The data were analyzed using the Wilcoxon signed-rank test. RESULTS: The study results indicate that (1) there was no significant difference in the mean spherical equivalent (SE) before cycloplegia between the two instruments ( P = 0.630); (2) a significant difference in mean SE after cycloplegia was observed for both instruments ( P < 0.001); (3) significant differences in mean SE after cycloplegia were noted for both instruments in cases of compound myopic astigmatism ( P < 0.001), compound hyperopic astigmatism ( P = 0.007), and mixed astigmatism ( P = 0.001); and (4) examination of all subjects showed undercorrection of autorefractometry results compared to those of retinoscopy. CONCLUSIONS: Retinoscopy and autorefractors yield different results for refractive error correction after cycloplegia. Therefore, autorefractor examination with cycloplegia cannot be considered a substitute for retinoscopy with cycloplegia.

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