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Cathy Williams, Rosemary Lumb, Ian Harvey, John M. Sparrow; Screening for Refractive Errors with the Topcon PR2000 Pediatric Refractometer. Invest. Ophthalmol. Vis. Sci. 2000;41(5):1031-1037.
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© ARVO (1962-2015); The Authors (2016-present)
purpose. The PR2000 (Topcon, Tokyo, Japan) is a photorefractor that has been
used in a population study comparing different methods of screening
preschool children. The present study was conducted to determine the
accuracy of the device in a largely clinical population.
methods. Two hundred twenty-two children less than 8 years of age were included.
All children were examined by an orthoptist using the PR2000 without
inducing cycloplegia. All children then underwent retinoscopy with
cycloplegia by an examiner who was unaware of the results from the
results. The PR2000 gave a numerical reading for 90% of the children’s right
eyes and the message “Out of range” for a further 5%. The readings
underestimated the amount of hypermetropic or astigmatic refractive
error found on retinoscopy by an amount proportional to the magnitude
of the refractive error. Agreement with retinoscopy for the axis of
astigmatism more than 0.75 D was moderately good (intraclass
correlation coefficient [ICC] = 0.63). The PR2000 was more useful as
a screener, especially for anisometropia for which it was 91%
sensitive and 92% specific. The repeatability was good for sphere
(ICC = 0.74), less so for astigmatism (ICC = 0.59), and
better than the optometrist for anisometropia (ICC = 0.38). The
presence of nonrefractive diagnoses and the age of the children
examined made little difference in the screening results.
conclusions. The PR2000 underestimated hypermetropic refractive errors when used
without cycloplegia. However, it was at least as good a screening
device as other similar instruments, especially when judged by its
ability to detect anisometropia and the repeatability of the
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