June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Pediatric refraction measurement with Inverse Shack-Hartmann device without cycloplegia
Author Affiliations & Notes
  • Ygal Rotenstreich
    Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
    Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • Noam Sapiens
    EyeQue Corp., Newark, California, United States
  • Ifat Sher-Rosenthal
    Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
    Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • Footnotes
    Commercial Relationships   Ygal Rotenstreich EyeQue Corp., Code F (Financial Support); Noam Sapiens EyeQue Corp., , Code E (Employment); Ifat Sher-Rosenthal EyeQue Corp., , Code F (Financial Support)
  • Footnotes
    Support  Eyeque research grant
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3304. doi:
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    • Get Citation

      Ygal Rotenstreich, Noam Sapiens, Ifat Sher-Rosenthal; Pediatric refraction measurement with Inverse Shack-Hartmann device without cycloplegia. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3304.

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

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Abstract

Purpose : Refraction error is the most prevalent vision deficiency. This is becoming especially pervasive in children, as myopia reaches unprecedented proportions. Pediatric refraction measurements require the use of cycloplegia. Hence two visits are required to determine children refraction. An alternative method that will alleviate these limitations is desired.

Methods : 35 children age 8-17 were enrolled. Refraction was determined using a new refraction measurement device by EyeQue Corp. and a standard autorefractor with and without cycloplegia. The new refraction device is based on the Inverse-Shack-Hartmann technology integrated in a binocular form factor presenting a stereoscopic background image simulating far vision. This was tested as the primary mechanism for controlling the accommodation. All children underwent Ishihara color testing, cover test, phoropter testing, best-corrected visual acuity, and slit lamp biomicrocopy. A Bland-Altman analysis was used to test the agreement between the autorefractor (Righton Retinomax K-plus 3) measurements and the EyeQue device measurements.

Results : A comparison between the EyeQue measurement without cycloplegia and the autorefractor measurement with cycloplegia shows a bias of -0.49D in spherical equivalent with limits of agreement of ±1.12D. This is comparable to the bias between the autorefractor measurements with and without cycloplegia of -0.75D and the EyeQue device with and without cycloplegia of -0.66D. Furthermore, the autorefractor with and without cycloplegia limit of agreement was ±1.04D, while the EyeQue device with and without cycloplegia limit of agreement was ±1.16D.

Conclusions : Rauscher et al. (2019) compared the Zeiss i.Profiler and found a bias of -0.55D with limits of agreement of ±1.1D. Harvey et al. (1997) compared the Nikon Retinomax and found a bias of -0.26D with limits of agreement of ±1.3D. Satou et al. (2019) compared the Welch-Allyn Spot and found a bias of -0.19D with limits of agreement of ±1.65D. Dahlmann-Noor et al. (2009) compared the PlusOptix Vision Screener and found a bias of over -1D with limit of agreement greater than ±2D. These results indicate that the EyeQue device performs similarly to a standard-of-practice autorefractor and better than other portable devices intended to be used with children. The device allows for effective accommodation mitigation without cycloplegia.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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