title: The usefulness of the Retinomax autorefractor for childhood screening validated against a Danish preterm cohort examined at the age of 4 years.
abstract: OBJECTIVE
  Refractometers have gained a foothold in childhood screening for ophthalmic disorders. Given the results of an ophthalmic follow-up of an extremely preterm Danish cohort, the results of the Retinomax autorefractor were further evaluated.
  
  
  METHODS
  A nationwide cohort of infants born before gestational age 28 weeks (n=178) and 56 term controls were examined at the age of 4 years. Refraction was given as the cycloplegic Retinomax value. For this study, we analysed the equipment's confidence value on the printout and equipment-induced myopization (as the difference between refraction measured before and after topical cyclopentholate 1%), both items hypothetical with a view to having identified factual ophthalmic deviations.
  
  
  RESULTS
  Thirty-two of 42 eyes with visual acuity ≤0.4 had high Retinomax confidence values (8-9); the Retinomax values were also high in 10 of 12 children with strabismus and lack of stereopsis. Low values (1-6) were recorded in 11 single eyes, 5 of which were normal (false positives). Three children already known to have low vision were unable to cooperate. The overall mean value for equipment-induced myopization was 1.9 D (range, 0-6.87 D). Myopization showed no correlation with visual acuity and corneal curvature, and a weak positive correlation with refractive value disappeared when the myopic outliers were excluded.
  
  
  CONCLUSIONS
  The hand-held Retinomax seemed to be reliable for assessing refraction in 4-year-old children, provided a cycloplegic agent is applied; if used alone, the Retinomax would have missed several cases of ophthalmic deviation during screening. Equipment-induced myopization was not indicative.
authors: Copenhagen University Eye Department, Glostrup Hospital & Rigshospitalet, Copenhagen, Denmark.
authors: H C
authors: HC
authors: Fledelius
authors: Copenhagen University Eye Department, Glostrup Hospital & Rigshospitalet, Copenhagen, Denmark.
authors: R
authors: R
authors: Bangsgaard
authors: Copenhagen University Eye Department, Glostrup Hospital & Rigshospitalet, Copenhagen, Denmark.
authors: C
authors: C
authors: Slidsborg
authors: Copenhagen University Eye Department, Glostrup Hospital & Rigshospitalet, Copenhagen, Denmark.
authors: M
authors: M
authors: laCour
mesh_terms: D000550:Amblyopia / Q000175:diagnosis; D015858:Anisometropia / Q000175:diagnosis; D002675:Child, Preschool; D003519:Cyclopentolate / Q000008:administration & dosage; D003718:Denmark; D005260:Female; D005865:Gestational Age; D006801:Humans; D007234:Infant, Premature; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D012030:Refractive Errors / Q000175:diagnosis*; D012178:Retinopathy of Prematurity / Q000175:diagnosis; D013285:Strabismus / Q000175:diagnosis; D015351:Vision Screening / Q000295:instrumentation*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009184:Mydriatics; D003519:Cyclopentolate