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M Courage, S Dalton, A Murphy, H Hall, RJ Adams; Effectiveness of the Welch Allyn SureSight Noncycloplegic Autorefractor for Testing Young Infants . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1502.
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Purpose: Early identification of infants with non-reducing levels of hyperopia and astigmatism as well as those who have significant myopia or anisometropia is critically important as development of the geniculostriate visual pathway relies on both accurate and balanced input from both eyes. Failure to provide this can result in permanent losses in visual acuity, binocularity, and deterioration of refractive status. Recent advances in noncycloplegic autorefractive technology designed to provide rapid, objective measurement of refractive status make this early identification of potential visual deficit possible. We used this technology to establish whether (1) it was effective for testing young infants (2) repeated measures agreed, and (3) results were comparable to those obtained with traditional cycloplegic techniques. Methods: Both eyes from 74 healthy 2 to12 month-old human infants were refracted twice with the new Welch Allyn SureSight (Welch Allyn, Inc., USA) noncycloplegic autorefractor. At least one reliable estimate of sphere and cylinder was obtained from both eyes of all babies attempted, and 80% of infants contributed two estimates from each eye, usually within 2 minutes. Results: Although spherical estimates changed little over the first year (M = +1.78D), cylindrical error appeared to decrease from about 1.4D (at 6 mo) to 0.8D (at 12 mo). Refractive estimates and variability agreed well with published infant data obtained with traditional cycloplegic retinoscopy. Repeatability was excellent for measurement of cylinder but for sphere, 17% of infants’ estimates differed by at least 1.0D between tests. Conclusion: Our results suggest that the values obtained with the SureSight are likely a good first approximation of refractive status in young infants and given its simplicity and time-efficiency, is a likely candidate for relatively easy screening of significant refractive error in non-verbal pediatric patients.
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