Steele Gregg, Ireland Dennis, Block Sandra
Illinois College of Optometry, 3241 S. Michigan Avenue, Chicago, IL 60616, USA.
Optom Vis Sci. 2003 Aug;80(8):573-7. doi: 10.1097/00006324-200308000-00010.
Early detection and treatment of amblyogenic conditions such as high refractive errors and anisometropia can help prevent the development of amblyopia. The traditional gold standard for the determination of refractive error in pre-school children is retinoscopy. Difficulties with retinoscopy in pre-school children have led to the development of autorefractors that can be free of operator bias and can be used by lay individuals. The Nikon Retinomax Plus handheld autorefractor has proven to be reliable for quick and accurate assessments of refractive errors in children. The Welch Allyn SureSight Vision Screener is a relatively new handheld autorefractor. The present study compares the results of measurements with the Retinomax Plus and the SureSight to the results of cycloplegic retinoscopy in pre-school children.
Thirty-five children ranging in age from 3 to 5 years old were subjects. Any subjects with strabismus, amblyopia, nystagmus, or ocular disease were excluded. Refractive error was assessed 30 min after the application of a cycloplegic spray.
Both autorefractors showed moderate agreement with cycloplegic retinoscopy results for measurement of spherical equivalent and cylinder power. In addition, the SureSight and the Retinomax Plus sphere and cylinder results showed moderate agreement with each other. Although the mean differences of the spherical equivalents determined were minimal, the 95% confidence intervals were large, which limits the value of the data obtained from each instrument.
Even though the Retinomax Plus and the SureSight appear to agree with each other and with the results of cycloplegic retinoscopy for determining sphere and cylinder power, interpretation of the data should be considered as screening only because the actual magnitude of sphere and cylinder may vary from the actual magnitude. These results suggest that either device may be useful only as screening tools for assessing refractive error in pre-school children.
早期发现并治疗诸如高度屈光不正和屈光参差等致弱视情况有助于预防弱视的发生。学龄前儿童屈光不正测定的传统金标准是检影验光。学龄前儿童检影验光存在困难，这促使了可避免操作者偏差且非专业人员也能使用的自动验光仪的发展。尼康Retinomax Plus手持式自动验光仪已被证明在快速准确评估儿童屈光不正方面是可靠的。伟伦SureSight视力筛查仪是一种相对较新的手持式自动验光仪。本研究比较了Retinomax Plus和SureSight的测量结果与学龄前儿童睫状肌麻痹检影验光的结果。
35名年龄在3至5岁的儿童作为研究对象。排除任何患有斜视、弱视、眼球震颤或眼部疾病的受试者。在使用睫状肌麻痹喷雾剂30分钟后评估屈光不正。
两种自动验光仪在测量等效球镜度和柱镜度数方面与睫状肌麻痹检影验光结果均显示出中度一致性。此外，SureSight和Retinomax Plus的球镜和柱镜结果彼此之间也显示出中度一致性。尽管所测定的等效球镜度的平均差异很小，但95%置信区间很大，这限制了从每种仪器获得的数据的价值。
尽管Retinomax Plus和SureSight在确定球镜和柱镜度数方面似乎彼此一致且与睫状肌麻痹检影验光结果一致，但数据解释应仅视为筛查，因为球镜和柱镜的实际度数可能与实际值有所不同。这些结果表明，这两种设备仅可作为评估学龄前儿童屈光不正的筛查工具。
