Examination of preschool children for ametropia: first experiences using a new hand-held autorefractor.
BACKGROUND
Over the last decades, various methods have been investigated for preschool screening for amblyogenic ametropia. The SureSight is a new hand-held wavefront-analyzing autorefractor designed for screening.


METHODS
A total of 338 children (3 1/2 - 4 1/2 years-old) were examined in their kindergartens without cycloplegia using the new instrument. Of these, 56 had a cycloplegic retinoscopy as a reference measurement. Hyperopia > or =3 dpt, myopia > or =1 dpt, astigmatism > or =1 dpt and anisometropia > or =1 dpt were considered amblyogenic ametropia.


RESULTS
Testability was 99.4%. Accuracy was high for cylinder power and axis but poor for the spherical equivalent. Sensitivity was 41% for the detection of amblyogenic hyperopia, 95% for astigmatism and 75% for anisometropia, with specificity values of 92, 79 and 73%.


CONCLUSIONS
The high testability and accuracy for cylinder power and axis are the strong points. The poor accuracy for the spherical equivalent is probably caused by the lack of cycloplegia. At present, non-cycloplegic autorefractor screening cannot be recommended due to the low specificity. Our findings support the advice that objective refraction in childhood must be performed with cycloplegia.
Büchner
Thomas F
TF
Ophthalmology Clinic, University Hospital, Muenster, Germany. buechnet@mednet.uni-muenster.de
Schnorbus
Ulrike
U
Grenzebach
Ulrike H
UH
Busse
Holger
H
D002675:Child, Preschool; D005189:False Positive Reactions; D006801:Humans; D011237:Predictive Value of Tests; D012030:Refractive Errors / Q000175:diagnosis*; D015203:Reproducibility of Results; D042262:Retinoscopy; D012680:Sensitivity and Specificity; D015351:Vision Screening / Q000295:instrumentation*