Vasudevan Balamurali, Ciuffreda Kenneth J, Meehan Kelly, Grk Dejana, Cox Misty
Midwestern University, Glendale, Arizona, USA.
Optometry - Vision Science, SUNY, New York, New York, USA.
Clin Exp Optom. 2016 Mar;99(2):168-72. doi: 10.1111/cxo.12367. Epub 2016 Feb 17.
The aim was to assess non-cycloplegic objective refraction in darkness using an open-field auto-refractor, and furthermore to compare it with distance cycloplegic subjective refraction and distance cycloplegic retinoscopy in the light, in children and young adults.
Twenty-three, visually-normal, young-adults (46 eyes) ages 23 to 31 years, and five children (10 eyes) ages five to 12 years, participated in the study. The spherical component of their refraction ranged from -2.25 D to +3.75 D with a mean of +1.80 D, and a mean cylinder of -0.70 D. Three techniques were used to assess refractive error. An objective measure of the non-cycloplegic refractive state was obtained using an open-field autorefractor (WAM-5500) after five minutes in the dark to allow for dissipation of accommodative transients and relaxation of accommodation. In addition, both distance retinoscopy and subjective distance refraction were performed following cycloplegia (Cyclopentolate, 1%) using conventional clinical procedures. All measurements were obtained on the same day within a single session. The spherical component of the refraction was compared among the three techniques in both the children and adults.
There was no significant difference in spherical refraction among the three techniques: non-cycloplegic objective refraction in the dark, distance cycloplegic retinoscopy and distance cycloplegic subjective refraction, in either the adults [F(2, 137) = 0.79, p = 0.45] or the children [F(2, 27) = 0.47, p = 0.62]. Mean difference in the spherical component between refraction in the dark and the cycloplegic distance retinoscopy was -0.34 D (r = 0.89) in the adults and +0.14 D (r = 0.96) in the children. The mean difference in spherical component between refraction in the dark and the cycloplegic distance subjective refraction was -0.25 D (r = 0.92) in the adults and -0.05 D (r = 0.95) in the children.
Comparison of the spherical refractive component between the three techniques was not significantly different and furthermore, they were highly correlated in both the children and adults in this pilot study. Non-cycloplegic refraction in the dark may provide a reliable adjunct or alternative to conventional cycloplegic refraction in both children and young adults.
本研究旨在使用开放视野自动验光仪评估黑暗环境下非散瞳客观验光，并将其与儿童和年轻人在明亮环境下的散瞳主观验光及散瞳视网膜检影法进行比较。
23名年龄在23至31岁之间视力正常的年轻人（46只眼）和5名年龄在5至12岁的儿童（10只眼）参与了本研究。他们的球镜度数范围为-2.25 D至+3.75 D，平均为+1.80 D，柱镜平均为-0.70 D。采用三种技术评估屈光不正。在黑暗环境中5分钟后，使用开放视野自动验光仪（WAM-5500）获得非散瞳屈光状态的客观测量值，以消除调节瞬变并使调节放松。此外，使用传统临床程序在散瞳（1%托吡卡胺）后进行视网膜检影和主观远距离验光。所有测量均在同一天的同一时段内进行。比较了儿童和成人中三种技术的球镜度数。
三种技术（黑暗环境下的非散瞳客观验光、散瞳视网膜检影法和散瞳主观验光）在球镜度数上无显著差异，在成人中[F(2, 137) = 0.79，p = 0.45]，在儿童中[F(2, 27) = 0.47，p = 0.
