Comparison of the Refractive Measurements with Hand-held Autorefractometer, Table-mounted Autorefractometer and Cycloplegic Retinoscopy in Children

Purpose: To evaluate the performance of the hand-held and table-top autorefractokeratometer in measuring refractive errors by comparing them with cycloplegic retinoscopy. Methods: Included in the study were 112 eyes of 112 pediatric patients whose mean age was 6.78 ± 2.61 years (range, 2 to 12 years). The refractive errors of all the eyes were measured with and without cycloplegia using a hand held autorefractokeratometer (Retinomax K-plus 3), table top autorefractokeratometer (Canon RK-F1) and performing cycloplegic retinoscopy. The spherical equivalent, cylindrical axis and keratometer values were statistically compared. Results: The mean spherical equivalent obtained from the Retinomax K-plus 3 was significantly less hyperopic than that of Canon RK-F1 (p = 0.004) before cycloplegia. When the Bland Altman analysis was performed in comparisons of spherical equivalent values measured with the Retinomax K-plus 3, Canon RK-F1 and cycloplegic retinoscopy, it was seen that almost all of the differences between the measurements remained within the range of ±2 standard deviation. Good agreement was found between Retinomax K-plus 3 and Canon RKF1 for the Jackson cross-cylinder values at axis 0° and 45°; keratometer values respectively. Conclusions: The refractive error components were highly correlated between the two instruments and cycloplegic retinoscopy.