Is the Sphere Value Measured by an Autorefractor Reliable in Children under Cycloplegia? Comparison with Streak Retinoscopy.

PURPOSE: To compare and repeatedly measure cycloplegic refraction in a cross-section of children using retinoscopy and automated refraction. METHODS: A total of 560 children (corresponding to 1120 eyes) ranging in age from 3 to 10 years participated in the study. Each child underwent a comprehensive eye examination, which included table mounted autorefractor evaluation (Kowa KW-2000) and streak retinoscopy, both after cycloplegia with 1% cyclopentolate hydrochloride. Data were analyzed using Fourier decomposition of the power profile. RESULTS: More positive values of M component and sphere value were given by cycloplegic autorefraction (AKW) compared with cycloplegic streak retinoscopy (RR). More negative values for the J45 vector and more positive for J0 were given AKW although this difference was not statistically significant. CONCLUSIONS: Our study shows that the table mounted autorefkeratometer Kowa KW- 2000 can be applied to young children with cycloplegia as instrument for cycloplegic refraction, and a discount of +0.67 should be applied on the sphere value. Similar care should be taken on the evaluation of the sphere and spherical equivalent values should be applied in other devices.