Non-Cycloplegic Retinomax vs Cycloplegic Retinoscopy

Medicine at a population scale is theoretically easy but very difficult – and possibly dangerous – in practice. We need to know if kiddos are able to see as well as they should, but how can they possibly tell us if they’ve never seen any better? They might need refractive correction to fix their nearsidedness, and they would not be able to tell us that. Because of this, we routinely do visual testing on kids, which can help, but its not completely accurate. We also want to do a test for if they need glasses, which is very easily done with an auto-refractor.

The problem is that kids can accomodate (meaning they can take their natural hyperopic prescription to a more myopic prescription by changing the shape of their lens by squeezing the ciliary muscle in the eye) really really well – much more than you or me! That means that even if we perform autorefraction on a kid, they might have a normal result but in practice, they could be very hyperopic and in need of glasses to see the board in school and to not have headaches, see their homework, etc.

In this study, we measured how well the autorefraction works by comparing, for each individual kid, the measurement before and after we gave them some eyedrops to temporarily relax their accomodation.

What did we find?

• Kids are accomodating an average of 1.95 ± 1.45 D.
• The difference was smaller in children who were nearsighted.
• For cylinder measurements of astigmatism), the difference was smaller, just -0.08 ± 0.43 D.
• Our referral screening criteria (for when kids need further testing were 66% accurate in identifying myopia (nearsightedness), 66% for hyperopia (farsightedness), and 98% for astigmatism, but with different levels of accuracy for each.