The effectiveness of an autorefractor with eye-tracking capability in pediatric patients.

Purpose: To study the diagnostic accuracy and effectiveness in children of a new autorefractor with eye-tracking capability.

Methods: Children aged 3-17 years were tested with a Marco Nidek ARK-560A autorefractor before and after cycloplegia. Cycloplegic manifest refractions were conducted on the more cooperative children. Measurements were converted to vector representations M (sphere), J0, and J45 (cylinder) by Fourier analysis and compared before and after cycloplegia for autorefractor measurements and clinical manifest and retinoscopic determinations.

Results: A total of 88 subjects were included. Autorefractor measurements were successfully obtained on all subjects. Before cycloplegia the mean spherical portion of the refractive error by autorefractor measurement (AR Dry) averaged 0.29 ± 0.75 D less hyperopia than the clinical manifest refraction (P < 0.005). After cycloplegia, mean autorefractor measurements (AR Wet) demonstrated 1.03 ± 0.84 D more hyperopia in the spherical component than AR Dry (P < 0.001). The spherical component of autorefraction and clinical measurements after cycloplegia were not statistically different, but the J0 astigmatic findings differed by 0.13 D ± 0.25 (P < 0.0003). For the 27 children under 8 years of age, precycloplegic autorefractor findings differed from manual cycloplegic retinoscopy by 1.48 D ± 1.13 for sphere (P < 0.001) but were not statistically different for astigmatic parameters.

Conclusions: Autorefractors can estimate manual retinoscopy values in children and may prove useful in the office setting in evaluating pediatric patients. Autotracking allowed successful acquisition of measurements in all subjects.