Abstract
Purpose: :
We sought to compare outcomes between adjustable spectacles and conventional measures of refractive error in children.
Methods: :
Rural Chinese school-children aged 12-18 years with uncorrected visual acuity ≤ 6/12 in either eye underwent self-refraction without cycloplegia, automated refraction without cycloplegia and subjective refraction with cycloplegia. Corrected and uncorrected vision, lines of vision improvement and spherical equivalent refractive error were measured.
Results: :
Among 648 participants (mean age 14.9 +/- 0.98 years, 59.3% girls, 44.4% wearing glasses, 60.6% with 2.00D or more of myopia in the right eye), 100% completed self-refraction. The proportion with better-eye visual acuity ≥ 6/7.5 with currently-worn spectacles, self-refraction, automated refraction, and subjective refraction were 30.2%, 96.9%, 98.4% and 99.1% respectively (self-refraction versus automated refraction P = 0.065, self-refraction versus subjective refraction P =0.006). Improvement in better-eye vision with self-refraction and subjective refraction was within +/-1 line in 98.0% of children. In logistic models, failure to achieve maximum recorded visual acuity of 6/6 in right eyes with self-refraction was associated with higher absolute value of myopia/hyperopia (P < 0.001) and higher astigmatism (P < 0.001), but not age, gender or previous glasses wear. Significant inaccuracies in power (≥ 1.00 Diopter) were less common in right eyes with self-refraction than automated refraction (4.8% versus 10.8%, P < 0.001).
Conclusions: :
Visual acuity with self-refraction was excellent in the large majority of these rural children with a significant burden of inadequately-corrected refractive error. Inaccurate power was less common with self-refraction than non-cycloplegic automated refraction.
Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques • myopia