Comparison of the cycloplegic refractive measurements with handheld, table-mounted refractometers and retinoscopy in children

Background: Handheld autorefractometers are now widely used for screening refractive errors in children. The purpose of the study was to compare the refractive measurements from table-mounted, handheld autorefractometers and retinoscopy in children. Material and methods: Measurements in children with poor visual acuity and/or strabismus were obtained with the handheld 2WIN and the table-mounted Nidek ARK-1 refractometers and retinoscopy after the instillation of 0.5% atropine. Data on the sphere, spherical equivalent (SE), and cylindrical vectors at 0 degrees (J0) and 45 degrees (J45) were analysed. Results: Data were collected from 57 children (mean age, 4.3 years ± 2.0 years). The 2WIN refractometer measure statistically significantly lower SE mean values than the Nidek ARK-1 or retinoscopy (1.67 ± 1.48 D, 2.96 ± 1.95 D, 2.92 ± 1.93 D, respectively). The 95% LOA was the narrowest for sphere, SE, J0, and J45 vector for Nidek ARK-1 refractometer and retinoscopy. The difference between the measurements of 2WIN and retinoscopy and 2WIN and Nidek ARK-1 was more pronounced in higher refractive values for sphere, SE, J0, and J45. Conclusion: The table-mounted autorefractor provided a reading more similar to that of streak retinoscopy than to that of the handheld autorefractor. The differences between the 2WIN and the other two methods were more pronounced in the higher refractive values, so careful interpretation of the autorefraction results would be advised,especially in children with higher refractive values who are at most significant risk for amblyopia