The compare the results of refraction measurement with or without cycloplegia in children aged 5-15 years with hand-held autorefractor (HO) and conventional autorefractor (CO).

Purpose: The aim of this study is to compare the results of refraction measurement with or without cycloplegia in children aged 5-15 years with hand-held autorefractor (HO) and conventional autorefractor (CO).Material and Methods: In this study, one hundred patients aged 5-15 years were classified according to their age group: Group 1 (5-10 years of age) and Group 2 (10-15 years of age). Firstly, refraction status with CO and HO were measured without cycloplegia in both groups. Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) of all patients were defined. Cycloplegia was performed 3 times with 10 minutes intervals to both eyes with topical eye drops. After 45 minutes, refraction status with CO and HO was measured with cycloplegia. Spherical, cyclindirical power and axis measurement of right eyes only were statistically compared.Results: In Group 1, there were 49 patients; 22 male and 27 female. Mean age of patients was 8.3 years. UCVA was 0.87±0.20 and BCVA was 0.99±0.28.Mean spherical measurement with CO was -0.55 ±1.40 D, with HO was 0.33 ±1.45 D before cycloplegia. Only 9 patients astigmatism detected upper ±0.50 D before cycloplegia, the cylindirical power with CO was 0.36 ±1.59 D, with HO was 0.44 ±1.54D, axis measurement with CO was 108.8 ±30.1°, with HO was 108.3 ±29.15°.After cycloplegia application, mean spherical measurement with CO was 1.09 ±1.39 D; with HO was 1.18 ±1.45 D. For the 9 patients astigmatism detected, the cylindirical power with CO was 0.38 ±1.45 D, with HO was 0.45 ±1.54 D, axis measurement with CO was 110±32.03°, with HO was 110±32.15°.In Group 2, there were 51 patients; 21 male and 30 female. Mean age of patients was 12.9. UCVA was 0.80±0.24 and BCVA was 1.00±0.00.Before cycloplegia application, mean spherical measurement with CO was -0.79 ±1.23 D, with HO was 0.20 ±1.25 D. For the 12 patients, astigmatism detected upper ±0.50 D before cycloplegia , the cylindirical power with CO was -0.16 ±1.25 D, with HO was 0.08 ±1.10 D, axis measurement with CO was 106.25 ±51.12°, with HO was 105.4 ±51.05°.After cycloplegia application, mean spherical measurement with CO was 0.32 ±1.41 D; with HO was 0.44 ±1.44 D. For the 12 patients astigmatism detected, the cylindirical power with CO was 0.18 ±1.37 D, with HO was -0.10 ±1.12 D, axis measurement with CO was 105±50.00°, with HO 108.49±52.15°.There was no statistically significant difference between UCVA of group 1 and group 2 and between BCVA of group 1 and group 2.In both of groups, there was statistically significant difference in spherical measurements of CO before and after cycloplegia. There was statistically significant difference in spherical measurements of HO before and after cycloplegia. Before cycloplegia, there was statistically significant difference between CO and HO in spherical measurement. CO measurement showed more miyopic acommodation shift than HO measurement. Before cycloplegia, there was no statistically significant difference between CO and HO cyclindirical and axis measurement. After cycloplegia, there was no statistically significant difference between CO and HO spherical, cyclindirical and axis measurement. There was no significant difference after and before cycloplegia with CO cyclindirical and axis measurement. Similarly former, there was no significant difference after and before cycloplegia with HO cylindirical and axis measurement. After cycloplegia with HO; spherical, cylindirical and axis measurement comparison of group 1 and group 2; group 1 was hyperopic at both the spherical and cylindirical power, group 2 was more emmetropic at the spherical, and more miyopic at the cylindirical power. The difference was statistically significant. But there was no significant diffrecence between axis measurement.Conclusion: The use of the autorefractors in children without cycloplegia may underestimate the actual hyperopia and overestimate the actual miyopia. However; HO working from a distance and showed less miyopic acomodative shift than CO. Astigmatic error and cyclindirical axis recordings were statistically similar by 2 methods before and after cycloplegia. This data means both of autorefractors do not affect cycloplegia and pupil dilation for measuring astigmatism and axis. We found portable autorefractor to be simple and easy to use. Portable autorefractor can use screening programs in the children.