Wave-front analysis as screening technique for amblyogenic ametropia with and without cycloplegia.
BACKGROUND
For many years, attempts have been made to find an easy, efficient and inexpensive method to screen children for amblyogenic ametropia. Wave-front analysis is a new way to determine the refractive state of the eye from a distance. This technique could be a useful tool for infant screening.


OBJECTIVE
The purpose of the study was the evaluation of the efficacy of a commercially available wave-front analyzing autorefractometer (SureSight, software version 2.0, Welch Allyn, Skaneateles Falls, NY 13153, U.S.A.) in detecting amblyogenic ametropia in patients with and without cycloplegia.


METHODS
256 eyes (-28.25 D to +7.88 D spherical equivalent) of 128 patients (1-81 years) were examined with the wave-front autorefractometer under cycloplegia. Prior to this investigation, 108 eyes (-21.38 D to 75 D) of 54 of these patients (1-76 years) were refracted without cycloplegia. The readings of the wave-front autorefractometer were compared with the results of retinoscopy under cycloplegia.


RESULTS
Without cycloplegia, the sensitivity in detecting any amblyogenic ametropia such as anisometropia, astigmatism, myopia or hyperopia was 94%, while the specificity was 63%. Following cycloplegia, the sensitivity decreased to 87% and the specificity increased to 80%.


CONCLUSIONS
Wave-front analyzing refractometry is highly applicable for infant screening. At the present state of development, the efficacy in detecting amblyogenic ametropia is similar to that of other screening techniques and instruments that operate from distance. Cycloplegia enhances the sensitivity in detecting hyperopia and decreases the sensitivity in detecting astigmatism.
Schimitzek
Thilo
T
Department of Neuro-ophthalmology & Strabismus, University Eye Clinic, Freiburg, Germany. Schimi@aug.ukl.uni-freiburg.de
Schworm
Hermann Dieter
HD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000550:Amblyopia / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003519:Cyclopentolate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009184:Mydriatics; D012030:Refractive Errors / Q000175:diagnosis* / Q000209:etiology*; D012031:Refractometry; D042262:Retinoscopy; D012680:Sensitivity and Specificity; D015351:Vision Screening / Q000379:methods
D009184:Mydriatics; D003519:Cyclopentolate