The Difference of Refraction Between the Cycloplegic Retinoscopy and Non-Cycloplegic Subjective Refraction in Children Aged 6 to 15 Years

Abstract

Objective: To determine the difference of refraction measured by cycloplegic retinoscopy (CR) and non-cycloplegic subjective refraction (NS). Materials and Methods: The present descriptive study included normal children aged 6 to 15 years with refractive error. The refractive status was measured by CR and cycloplegic autorefractometer (CA) at the initial visit. At 2-week follow-up, the refraction was measured with non-cycloplegic autorefractometer (NA) and NS. The spherical equivalent (SE) from participants’ right eye was used in the data analyses. Results: Forty-four participants were included in this study with a mean age of 9±3 years and 22 (50%) were male. Overall, the median (Q₁, Q₃) of SE by CR, CA, NS, and NA were –1.00 (–2.50, 0.25), –1.63 (–2.63, –0.50), –1.63 (–2.50, –1.00), and –1.88 (–2.88, –1.13) diopters (D), respectively. The SE by CR was 0.56 D more than NS (p<0.001), and 0.38 D more than CA (p<0.001). The SE by NS was 0.25 D more than NA (p=0.008). By using the CR method, 11 (25%) participants were classified in the hyperopic group (positive SE) and 33 (75%) in the myopic group (negative SE). In the hyperopic group, the median (Q₁, Q₃) of SE by CR and NS were 0.75 (0.50, 1.75) and –0.63 (–1.00, 1.38) D, respectively. The refraction by CR was 1.50 D more than by NS (p=0.003). In the myopic group, the median (Q₁, Q₃) of SE by CR and NS were –1.50 (–2.50, –0.75) and –2.00 (–3.25, –1.50) D, respectively. The refraction by CR was 0.50 D more than NS (p<0.001). Conclusion: The refraction in children aged 6 to 15 years measured by CR was significantly more than NS in the participants. The authors should decrease the number of refractions obtained from CR when prescribing glasses to hyperopic children. Keywords: Refractive error, Children, Cycloplegic retinoscopy, Subjective refraction, Cycloplegic autorefractor, Manifest autorefractor