Clinical evaluation of refraction using a handheld wavefront autorefractor in young and adult patients.

PURPOSE

To determine the accuracy of measurement by the SureSight autorefractor (software version 2.0) and the influence of accommodation.

SETTING

Pediatric Section, Department of Ophthalmology, University of Hamburg, Hamburg, Germany.

METHODS

In a series of comparative measurements, autorefractor readings were compared with cycloplegic retinoscopy in 195 eyes of 108 patients (1 to 81 years) measured under cycloplegia. Ninety-six eyes were also measured without cycloplegia.

RESULTS

The wavefront autorefractor was able to refract human eyes from a distance of 0.35 m. The accuracy was lower than that with conventional tabletop autorefractors. A difference of less than 0.51 diopter (D) was found in 68% of the spherical equivalents under cycloplegia. Many emmetropic and hyperopic children accommodated during the noncycloplegic measurements and were minus-overcorrected up to -6.13 D. In our group of young patients (2 to 17 years), 47% were minus-overcorrected by more than -2.00 D.

CONCLUSIONS

The wavefront autorefractor uses a new method to determine the refractive state of the eye from a distance. It was less accurate than other conventional autorefractors. A benefit is its application in infants and disabled and uncooperative subjects. Cycloplegia is necessary in young hyperopic patients.