Comparison of non-cycloplegic photorefraction,cycloplegic photorefraction and cycloplegic retinoscopy in children

AIM: To compare the results of noncycloplegic photorefraction, cycloplegic photorefraction and cycloplegic refraction in preschool and non-verbal children.METHODS: One hundred and ninety-six eyes of 98children(50 females, 48 males) were included in the study. Firstly, non-cycloplegic photorefraction was achieved with Plusoptix A09; secondly, cycloplegic photorefraction was carried out with Plusoptix A09 after10 min cyclopentolate. Finally, 30 min after instillation of twice cyclopentolate, cycloplegic refraction was obtained with autorefraction and/or standard retinoscopy. Spheric equivalent, spheric power, cylindric power and cylindrical axis measurements were statistically compared.RESULTS: The mean age was 28.8±18.5mo(range12-72mo). The differences in spherical equivalent, spheric power and cylindrical power measured by the three methods were found statistically significant(P 【0.05).The spherical equivalent and spheric power measured by cycloplegic photorefraction were statistically higher than the measurements of the other methods(P 【0.05). The cylindrical power measured by cycloplegic refraction was statistically lower than the measurements of the photorefraction methods(P 【0.05). There was no significant difference in cylindrical axis measurements between three methods(P 】0.05).CONCLUSION: For the determination of refractive errors in children, the Plusoptix A09 measurements give incorrect results after instillation of cyclopentolate.Additionally, the cylindrical power measured by Plusoptix A09 with or without cycloplegia is higher. However, the non-cycloplegic Plusoptix A09 measures spheric equivalent and spheric power similar to cycloplegic refraction measurements in preschool and non-verbal children.

Comparison of the Retinomax hand-held autorefractor versus table-top autorefractor and retinoscopy

AIM:To compare noncycloplegic and cycloplegic results of Retinomax measurements with findings achieved after cycloplegia using table-top autorefractor and retinoscopy.METHODS:The study included 127 patients(mean age96.7mo,range 21 to 221).Retinomax(Rmax)(Nikon Inc.,Japan)was used to obtain noncycloplegic refraction.Under cycloplegia,refraction was measured with Rmax,table-top autorefractor(TTR)(Nikon NRK 8000,Inc.,Japan)and retinoscopy.The values of sphere,spherical equivalent,cylinder and axis of cylinder were recorded for Rmax,TTR and retinoscopy in each eye.All results were analyzed statistically.RESULTS:The mean spheric values(SV),spherical equivalent values(SEV)and cylindrical values(CV)of the noncycloplegic Rmax(SV:0.64 D,SEV:0.65 D and CV:0.03 D,respectively)were found to be significantly lower than cycloplegic TTR(1.43 D,1.38 D and 0.3 D;P=0.012,P=0.011 and P=0.04,respectively)and retinoscopy(1.34 D,1.45 D and 0.23 D;P=0.04,P=0.002 and P=0.045,respectively).Mean cycloplegic SV,SEV,CV were not significantly different between Rmax and TTR,Rmax and retinoscopy,TTR and retinoscopy.Cycloplegic or noncycloplegic axis values were not different between any method.CONCLUSION:Rmax may be used successfully as a screening tool but may not be accurate enough for actual spectacle prescription.Cycloplegic Rmax measurements may be able to identify refractive error in children because of approximate results to retinoscopy.

Non-cycloplegic spherical equivalent refraction in adults:comparison of the double-pass system,retinoscopy,subjective refraction and a table-mounted autorefractor

AIM:To evaluate the accuracy of spherical equivalent(SE) estimates of a double-pass system and to compare it with retinoscopy,subjective refraction and a table mounted autorefractor.METHODS:Non-cycloplegic refraction was performed on 125 eyes of 65 healthy adults(age 23.5±3.0 years) from October 2010 to January 2011 using retinoscopy,subjective refraction,autorefraction(Auto kerato refractometer TOPCON KR-8100,Japan) and a double pass system(Optical Quality Analysis System,OQAS,Visiometrics S.L.,Spain).Nine consecutive measurements with the double-pass system were performed on a subgroup of 22 eyes to assess repeatability.To evaluate the trueness of the OQAS instrument,the SE laboratory bias between the double pass system and the other techniques was calculated.RESULTS:The SE mean coefficient of repeatability obtained was 0.22D.Significant correlations could be established between the OQAS and the SE obtained with retinoscopy(r=0.956,P【0.001),subjective refraction(r=0.955,P【0.001) and autorefraction(r=0.957,P【0.001).The differences in SE between the double-pass system and the other techniques were significant(P【0.001),but lacked clinical relevance except for retinoscopy;Retinoscopy gave more hyperopic values than the double-pass system-0.51±0.50D as well as the subjective refraction-0.23±0.50D;More myopic values were achieved by means of autorefraction 0.24±0.49D. CONCLUSION:The double-pass system provides accurate and reliable estimates of the SE that can be used for clinical studies.This technique can determine the correct focus position to assess the ocular optical quality.However,it has a relatively small measuring range in comparison with autorefractors(-8.00 to +5.00D),and requires prior information on the refractive state of the patient.

Quantitative relationship between pupillary reflex feature and its diopter in retinoscopy

The quantitative relationship between the pupillary reflex feature of retinoscopy and its refractive diopter has been studied by means of combining the S-picture system with the further mathematical and optical methods.A series of new formulas on retinoscopy has been set up for the first time. The correlation coefficient of the results obtained by formula calculation,photograph analysis and retinoscopy on 2000 eyes is -0.93,-0.97 and -0.95 respectively(P<0. 01 ),indicating the negative relationship between the value of the feature's character parameter and its diopter. There is no difference between the 3 groups(X2 test P>0. 05). These new formulas and findings develop the theories of retinoscopy and provide a more speedy and accurate strategy for clinical practice,making it possible to create a new automatic retinoscopic instrument.

Retinoscopes:Past and present

BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all ages,and usefulness in patients with limited cooperation or communication skills.AIM To discuss the history of retinoscopes and examine current literature on the subject.METHODS A search was conducted on the PubMed and with the reference citation analysis(https://www.referencecitationanalysis.com)database using the term"Retinoscopy,"with a range restricted to the last 10 years(2013-2023).The search string algorithm was:"Retinoscopy"(MeSH Terms)OR"Retinoscopy"(All Fields)OR"Retinoscopes"(All Fields)AND[(All Fields)AND 2013:2023(pdat)].RESULTS This systematic review included a total of 286 records.Publications reviewed iterations of the retinoscope into autorefractors,infrared photo retinoscope,television retinoscopy,and the Wifi enabled digital retinoscope.CONCLUSION The retinoscope has evolved significantly since its discovery,with a significant improvement in its diagnostic capabilities.While it has advantages such as non-invasiveness and broad applicability,limitations exist,and the need for skilled interpretation remains.With ongoing research,including the integration of artificial intelligence,retinoscopy is expected to continue advancing and playing a vital role in eye care.

Comparison of computer photoscreening with non cycloplegic retinoscopy for amblyopiogenic risk factors in children

To determine the sensitivity and specificity of using a computer photoscreener and non cycloplegic retinoscopy in the detection of amblyopiogenic factors in nine to fifty months old infants and children Methods Three hundred children, nine to fifty months old, were screened with the computer photoscreener and non cycloplegic retinoscopy With a blinded standardized clinical assessment as the standard, an overall comparison of the sensitivity of and specificity results obtained with the two techniques was made Photoscreen images on the computer monitor screen were reviewed and analyzed immediately by two independent observers for indicators of amblyopiogenic risk factors Simultaneously, the results were compared to the findings of a full ophthalmologic examination Results The computer photoscreener revealed a sensitivity of 94 6% and specificity of 90 1%, and the non cycloplegic retinocopy revealed a sensitivity of 85 7% and specificity of 81 0% for the detection of amblyopiogenic risk factors, including hyperopia (+2 75 D or more), myopia (-1 50 D or more), astigmatism (1 75 D or more), anisometropia (2 00 D or more), ocular misalignment (5 degrees or more), and media opacity (1 5?mm or more) Conclusions The computer photoscreener offers an opportunity to identify problems that limit vision, and could provide a feasible and sufficiently reliable screening technique in infants and preschool children to be screened successfully for amblyopiogenic risk factors

The evolution of refractive status in Chinese infants during the first year of life and its affected factors

AIM： To study the evolution of the refractive status and examine the affected factors in infants during the first year of life in a large sample size in China. METHODS： A total of 1258 babies （2516 eyes） aged 32wk gestational age to ty participated in the study, including 766 premature and 492 full-term infants. First, each baby received an orthoptic examination, slit-lamp checking and fundus imaging. Patients with diseases which might affect refractive status were excluded from the cohort. The cycloplegia retinoscopy was performed. Their neonatal histories were reviewed. Each measurement contained the refractive status and calculation of the spherical equivalent （SE）. RESULTS： Refractive state showed an average hyperopia of ＋0.94_＋1.63 D at early ages, followed by a trend toward more hyperopia. The refractive state reached the top （＋2.431.46 D） at the age of one to two months. Then gliding till one year old when the refractive state reached ＋0.59：1.41 D. The prevalence of astigmatism was 42.17% in the study, being 2.82% myopic astigmatism and 39.35% hyperopic astigmatism. The 94.1% of hyperopic astigmatism was with-the-rule astigmatism and 71.83% of myopic astigmatism was with-the-rule astigmatism. Refractive state between boys and girls was different. The mean SE of boys was ＋1.97＋1.57 D, while that of girls was ＋1.79＋1.46 D, and the difference was significant. CONCLUSION： Before one year old, the change of refractive status is associated with checking age and sex. At the age of one to two months, the degree of hyperopia reaches the top. Boys have more hyperopic degree than girls, and with- the-rule astigmatism is predominant. Excluding premature infants with advanced retinopathy of prematurity, premature and full-term children have same refraction status.

Measurement of corneal astigmatism

Cornea is the most important optical surface in the eye dioptric system. Three kinds of methods in measuring corneal astigmatism were used. Three hundred and sixty eyes suffered ametropia were selected on a random basis. Computer_assisted corneal topographic system was compared with keratometer and cycloplegic retinoscopy in measuring corneal curvature. There was no statistical difference in axes of astigmatism among the three groups. It is thought that ΔSim \%K\% could show the corneal regular astigmatism. As for diopters of astitigmatism, no difference was found between the groups of corneal topography and keratometer, but there was a significant difference between the group of cycloplegic retinoscopy and the other two groups. It was demonstrated that keratometer could function similarly as the corneal topography. However, it measured only four points from a small region of the cornea and was limited in measuring slight changes in corneal curvature. Some discussion was also made about the graphic patterns and ΔSim \%K\% in corneal topography.