Abstract
Abstract
Purpose
To compare school-age children’s objective and subjective refraction using a binocular wavefront optometer (BWFOM) with autorefraction and retinoscopy before and after cycloplegia.
Methods
Eighty-six eyes from 86 children (6–15 years old) were enrolled in this cross-sectional study. BWFOM objective and subjective refractions were compared with autorefraction and retinoscopy under cycloplegia. BWFOM refraction was evaluated before and after cycloplegia. Measurements were compared using a paired t-test; agreement was assessed using Bland–Altman plots.
Results
Under cycloplegia, the sphere, spherical equivalence, and J45 were significantly more negative on BWFOM objective refraction than autorefraction (− 1.39 ± 2.20 D vs. − 1.28 ± 2.23 D, P = 0.003; − 1.84 ± 2.38 D vs. − 1.72 ± 2.43 D, P = 0.001; − 0.02 ± 0.17 D vs. 0.03 ± 0.21 D, P = 0.004). The subjective sphere of BWFOM was less myopic, and the cylinder and the J45 were more negative than those with retinoscopy (− 1.17 ± 2.09 D vs. − 1.25 ± 2.20 D, P = 0.02; − 0.91 ± 0.92 D vs. − 0.76 ± 0.92 D, P < 0.001; − 0.01 ± 0.15 D vs. 0.03 ± 0.21 D, P = 0.028). For both BWFOM objective and subjective refraction, sphere and spherical equivalence with noncycloplegia were more myopic than those with cycloplegia (objective: − 1.76 ± 2.10 D vs. − 1.39 ± 2.20 D, − 2.21 ± 2.30 D vs. − 1.84 ± 2.38 D, P < 0.001; subjective: − 1.57 ± 1.92 D vs. − 1.17 ± 2.09 D, − 2.01 ± 2.13 D vs. − 1.62 ± 2.27 D, P < 0.001). Bland–Altman plots showed good agreement in spherical equivalence between BWFOM objective refraction and autorefraction (mean difference = 0.12 D, 95% confidence interval [CI] − 0.52 to 0.76), subjective refraction with retinoscopy (mean difference = − 0.01 D, 95% CI − 0.65 to 0.64), and BWFOM refractions with or without cycloplegia (objective: mean difference = − 0.37 D, 95% CI − 1.31 to 0.57; subjective: mean difference = − 0.39 D, 95% CI − 1.30 to 0.51). The time cost by BWFOM was significantly less than the total time of autorefraction and retinoscopy (264.88 ± 90.67 s vs. 315.89 ± 95.31 s, P < 0.001).
Conclusion
BWFOM is a new device that realizes both objective and subjective refraction. For children’s refractive errors, it is more convenient and quicker to obtain the proper prescription at a 0.05-D interval, and it is more accurate than autorefraction and retinoscopy under cycloplegia.
Funder
National Natural Science Foundation of China
Project of Shanghai Science and Technology
Publisher
Springer Science and Business Media LLC
Subject
Cellular and Molecular Neuroscience,Sensory Systems,Ophthalmology
Cited by
4 articles.
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