title: Accuracy of the Retinomax K-plus3 in measuring refractive error in a pediatric population.
abstract: OBJECTIVE
  To compare the Retinomax K-plus3 handheld autorefractor to a retinscopically based refraction performed by a pediatric ophthalmologist.
  
  
  METHODS
  The medical records of 311 children aged 5 months to 17 years who underwent cycloplegic refraction by both autorefractor and a pediatric ophthalmologist on the same day were retrospectively reviewed. Spherical equivalent, vector dioptric distance (VDD) values, and t tests were performed for each metric with an accompanying age-group comparison (<5 years, 5-7 years, 8-10 years, and ≥11 years). Bland-Altman plots were generated to evaluate the agreement between methods.
  
  
  RESULTS
  Overall, the refraction provided by the Retinomax autorefractor was not significantly different in regard to cylinder power and axis. An age-group comparison showed statistically similar readings for all measures of refractive error in children 8-10 years of age. Statistically similar readings were obtained for cylinder power and axis except in children aged 5-7 years. The VDD was statistically different between the two methods for every age group. Bland-Altman plots suggested agreement between the two approaches for the entire cohort with respect to sphere, cylinder, axis, and spherical equivalent.
  
  
  CONCLUSIONS
  In children <18 years of age, there was no clinical difference in the cycloplegic refraction determined by the Retinomax autorefractor when compared to retinoscopy by a pediatric ophthalmologist.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins School of Medicine.
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Peng
authors.affiliation: Family Eye Group, Lancaster, Pennsylvania. Electronic address: noellematta@gmail.com.
authors.forename: Noelle
authors.initials: N
authors.lastname: Matta
authors.affiliation: Family Eye Group, Lancaster, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Silbert
authors.affiliation: Wilmer Eye Institute, Johns Hopkins School of Medicine.
authors.forename: Jing
authors.initials: J
authors.lastname: Tian
authors.affiliation: Wilmer Eye Institute, Johns Hopkins School of Medicine.
authors.forename: Eric
authors.initials: E
authors.lastname: Singman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003519:Cyclopentolate / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D011680:Pupil / Q000187:drug effects; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000175:diagnosis*; D015203:Reproducibility of Results; D042261:Retinoscopes; D042262:Retinoscopy / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D009184:Mydriatics; D003519:Cyclopentolate