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  • Title: Accuracy of noncycloplegic autorefraction in school-age children in China.
    Author: Zhao J, Mao J, Luo R, Li F, Pokharel GP, Ellwein LB.
    Journal: Optom Vis Sci; 2004 Jan; 81(1):49-55. PubMed ID: 14747761.
    Abstract:
    PURPOSE: To evaluate the accuracy of noncycloplegic autorefraction in a representative sample of school-age children in China. METHODS: Refractive error was measured with an autorefractor, both before and after cycloplegia induced with cyclopentolate, in a population-based sample of 4973 children between the ages of 7 and 18 years. Spherical equivalent refractive error and astigmatism as represented by Jackson crossed-cylinders (J0 and J45) were the main outcome measures. RESULTS: Noncycloplegic measurements of equivalent spheres were consistently more negative or less positive than those after cycloplegia, with mean +/- SD differences of -1.23 +/- 0.97 D. The differences were particularly large for hyperopic eyes (mean difference of -2.98 +/- 1.65 D for hyperopia of at least +2.00 D) while becoming progressively smaller for emmetropic eyes, and smaller yet for myopic eyes (mean difference of -0.41 +/- 0.46 D for myopia of -2.00 D or more). Increasing age was associated with increased, but clinically insignificant, differences. Little difference was found between noncycloplegic and cycloplegic measurements of astigmatism: mean J0 and J45 differences were -0.08 +/- 0.13 D and -0.01 +/- 0.09 D, respectively. CONCLUSIONS: Noncycloplegic autorefraction was found to be highly inaccurate in school-age children and, thus, not suitable for studies of refractive error or for prescription of glasses in this population.
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