Auto-objective accommodative measurements as a valid and reliable new method of pediatric, strabismus and amblyopia, vision screening.

Abstract

Purpose: Recent technological advances in photoscreening devices have improved their performance for pediatric vision screening. Monocular noncycloplegic autorefractors have also been used but cannot assure that accommodation is held constant between the two eyes. In this study we utilized a simple childrens near autorefraction without correction on the open field Grand Seiko autorefractor to determine if it alone could be a viable method of pediatric vision screening to detect amblyopia risk factors.

Design: Retrospective chart review.

Participants: Fifty-two consecutive children with known amblyopia risk factors were enrolled into this study.

Methods: Children had their accommodation measured at one third of a meter without glasses correction.

Main outcome: In our study children with amblyopia or amblyopia risk factors were found to have abnormal readings indicating either poor ability to focus, or high refractive error. All children measuring minus 1.25 diopter of sphere or higher (less negative), or measuring plus 1.25 diopters of astigmatism or more without correction were found to have amblyogenic factors based on the standard, AAPOS referral criteria.

Conclusion: Children with amblyopia or amblyopia risk factors have classifiably abnormal autorefraction readings at near on the Grand Seiko binocular open field autorefractor. Measuring near autorefraction utilizing the Grand Seiko autorefractor may be a new and viable option for pediatric vision screening in the medical home (defined as the patients primary care doctor, which in this case could be a family doctor or a pediatrician).