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The Difference of Refraction Between the Cycloplegic Retinoscopy and Non-Cycloplegic Subjective Refraction in Children Aged 6 to 15 Years

Honglertnapakul W, MD¹ , ², Jindarak P, MD¹ , ², Praneeprachachon P, MD¹ , ² , ³, Pukrushpan P, MD¹ , ² , ³

Affiliation : ¹ Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ² Department of Ophthalmology, King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Bangkok, Thailand ³ Rutnin Eye Hospital, Bangkok, Thailand


Objective: To determine the difference of refraction measured by cycloplegic retinoscopy (CR) and non-cycloplegic subjective refraction (NS).
Materials and Methods: The present descriptive study included normal children aged 6 to 15 years with refractive error. The refractive status was measured by CR and cycloplegic autorefractometer (CA) at the initial visit. At 2-week follow-up, the refraction was measured with non-cycloplegic autorefractometer (NA) and NS. The spherical equivalent (SE) from participants’ right eye was used in the data analyses.
Results: Forty-four participants were included in this study with a mean age of 9±3 years and 22 (50%) were male. Overall, the median (Q₁, Q₃) of SE by CR, CA, NS, and NA were –1.00 (–2.50, 0.25), –1.63 (–2.63, –0.50), –1.63 (–2.50, –1.00), and –1.88 (–2.88, –1.13) diopters (D), respectively. The SE by CR was 0.56 D more than NS (p<0.001), and 0.38 D more than CA (p<0.001). The SE by NS was 0.25 D more than NA (p=0.008). By using the CR method, 11 (25%) participants were classified in the hyperopic group (positive SE) and 33 (75%) in the myopic group (negative SE). In the hyperopic group, the median (Q₁, Q₃) of SE by CR and NS were 0.75 (0.50, 1.75) and –0.63 (–1.00, 1.38) D, respectively. The refraction by CR was 1.50 D more than by NS (p=0.003). In the myopic group, the median (Q₁, Q₃) of SE by CR and NS were –1.50 (–2.50, –0.75) and –2.00 (–3.25, –1.50) D, respectively. The refraction by CR was 0.50 D more than NS (p<0.001).
Conclusion: The refraction in children aged 6 to 15 years measured by CR was significantly more than NS in the participants. The authors should decrease the number of refractions obtained from CR when prescribing glasses to hyperopic children.
Received 15 Jan 2020 | Revised 2 Apr 2020 | Accepted 7 Apr 2020

doi.org/10.35755/jmedassocthai.2020.06.11010

Keywords : Refractive error, Children, Cycloplegic retinoscopy, Subjective refraction, Cycloplegic autorefractor, Manifest autorefractor


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