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TF Buchner, U Schnorbus, UH Grenzebach, H Busse; Examination of Children for Refractive Errors in the Kindergarten Using a Hand-Held Autorefractor . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1503.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Objective measurement of refraction with tabletop autorefractors can be difficult or even impossible when dealing with uncooperative persons like many preschool children. However, screening children at preschool age for ametropia is useful to prevent amblyopia. Non-contact examination from a short distance with new instruments was introduced to improve the compliance. Methods: 338 children (676 eyes) aged 3,5-4,5 years were examined for refractive errors in the kindergarten using the hand-held autorefractor "SureSight tm" (WelchAllyn) without cycloplegia. Reproducibility was tested by comparing the refraction data of repeated measurements in 380 eyes. Accuracy of autorefractor readings was estimated by comparing them with retinoscopy results obtained in cycloplegia (59 eyes). Results: Measurements with the "SureSight tm" autorefractor could be performed easily. Cooperation was excellent: 336 children (99%) were succesfully examined. Most eyes had a mild hyperopia and an astigmatism of less than 1.0 D. The results of cylinder power and axis showed a good reproducibilty and accuracy. However, only 15.3% of the automatically determined sherical equivalents differed by 0.5 D or less from retinoscopy results in cycloplegia. The difference in spherical equivalent of repeated measurements was 0.5 D or less in 53.9% (379 eyes). Conclusion: The "SureSight tm" autorefractor appears to be a useful tool for screening preschool children for refractive errors. This quick and convenient procedure can be applied succesfully to almost all children in this age group. We do not recommend the use of these autorefractor readings for the prescription of spectacles due to the deviation from retinoscopic measurements in many cases.
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