Self-refraction noninferior to autorefraction in young children
Key takeaways:
- The proportion of participants who achieved a visual acuity of 20/25 or better was similar for all types of refraction.
- Self-refraction produced a clinically insignificant increase in myopic power.
Self-refraction using adjustable-focus spectacles in children was noninferior and more hyperopic compared with noncycloplegic autorefraction, according to a study published in JAMA Ophthalmology.
“Results suggest that self-refraction using adjustable-focus spectacles among children aged 5 to 11 years was noninferior to (and resulted in more hyperopic power than) noncycloplegic autorefraction, although self-refraction with adjustable-focus spectacles may result in more myopic power than cycloplegic refraction but not necessarily to a clinically relevant degree,” Lloyd Zhao, MD, from the department of ophthalmology at Duke University Medical Center, and colleagues wrote.
Researchers conducted a cross-sectional, noninferiority trial of 112 children (median age, 9 years; 46.4% boys) with uncorrected visual acuity of 20/40 or worse in one or both eyes and assessed spherical equivalent refractive error and visual acuity with self-refraction, noncycloplegic autorefraction and cycloplegic refraction.
Participants performed self-refraction twice using fluid-filled, adjustable-focus spectacles, and researchers assessed corrected visual acuity for noncycloplegic autorefraction and self-refraction. All participants also were given cyclopentolate 1% and phenylephrine 2.5% eye drops as part of the examination, and a pediatric optometrist or ophthalmologist performed retinoscopy or subjective cycloplegic refraction at least 30 minutes after the administration of drops.
The researchers reported that 79.5% of participants who underwent self-refraction had a corrected visual acuity of 20/25 or better compared with 85.7% with noncycloplegic autorefraction and 79.5% with cycloplegic refraction. The average spherical equivalent refractive power was –2 D for self-refraction, –2.32 D for noncycloplegic autorefraction and –1.67 D for cycloplegic refraction.
“Use of adjustable-focus spectacles may help address uncorrected refractive error among children aged 5 to 11 years in under-resourced areas,” Zhao and colleagues wrote.
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