May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Variability of Autorefractor Measurement in Infants, Children and Adults:The Welch Allyn SureSight
Author Affiliations & Notes
  • M. Courage
    Depts. of Psychology & Pediatrics, Faculties of Science & Medicine, Memorial Univ of Newfoundland, St John's, NF, Canada
  • S.M. Drodge
    Depts. of Psychology & Pediatrics, Faculties of Science & Medicine, Memorial Univ of Newfoundland, St John's, NF, Canada
  • M.E. Mercer
    Depts. of Psychology & Pediatrics, Faculties of Science & Medicine, Memorial Univ of Newfoundland, St John's, NF, Canada
  • R.J. Adams
    Depts. of Psychology & Pediatrics, Faculties of Science & Medicine, Memorial Univ of Newfoundland, St John's, NF, Canada
  • Footnotes
    Commercial Relationships  M. Courage, None; S.M. Drodge, None; M.E. Mercer, None; R.J. Adams, None.
  • Footnotes
    Support  NSERC 03–372
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4314. doi:
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      M. Courage, S.M. Drodge, M.E. Mercer, R.J. Adams; Variability of Autorefractor Measurement in Infants, Children and Adults:The Welch Allyn SureSight . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4314.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:In recent years, several hand–held, portable and user friendly autorefractors have emerged to provide rapid measurements of spherical and cylindrical refractive error for a wide variety of clinical patients. The Welch Allyn SureSight is perhaps the most flexible and user/patient friendly of these devices as it is targeted for very young pediatric patients and is calibrated for use without cycloplegia. To date, there has been little evaluation of the effectiveness of this device, in particular, the consistency of non–cycloplegic measurements and comparability to those obtained with formal clinical techniques. Methods:Within a single session, we used the SureSight to obtain two measurements of the right eye in infants (5–19 mo, n=86), preschoolers (2–5 yr, n=87), school–age children (7–10 yr, n=102) and young adults (19–25 yr, n=112). The adults, (range = –10 to +7.75D sph; 0 to 3.5 cyl) were also tested on two separate occasions over the next month. Adult data were compared to non–cycloplegic measurements obtained with formal clinical autorefractive instrumentation. Results: In general, age and the variability of refractive measurements were inversely related. The mean absolute test–retest difference for sphere was 0.26D (SD=0.21D) for adults compared to 0.40D (SD =0.44D) for school children, 0.61D (SD = 0.66D) for preschoolers and 0.78D (SD = 0.52D) for infants. The trend for cylinder was similar but with less variability within each group (Mean diff. = 0.31D, 0.22D, 0.18D, and 0.12D for infants, preschoolers, school children and adults, respectively). One way ANOVA revealed that for both cylinder and sphere, the developmental trend was significant (both p < 0.01). For adults, measurement variability increased over time (e.g., spherical estimates separated by a month differed by 0.60D compared to 0.26D within a session, p< .001). Finally, comparison with clinical measurements revealed that the autorefractor underestimated sphere by 0.80D and cylinder by 0.24D. Conclusions:The Welch Allyn SureSight autorefractor likely provides reasonable first estimates of refractive error for a broad patient population. However, estimates are much less stable in younger patients, are more variable over sessions in older subjects and appear to underestimate spherical error somewhat. Nonetheless, given these shortcomings (likely due to accommodation–related factors), the SureSight's efficiency and flexibility make it, for many patients, (e.g. young infants), perhaps the only practical option for estimating refractive error.

Keywords: refractive error development • infant vision • refraction 
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