Inability of Open-Field Autorefraction to Eliminate Accommodation in Preschoolers.

Purpose: To evaluate the effectiveness of the Shin-Nippon NVision-K 5001 autorefractometer (Rexxam Co. Ltd., Osaka, Japan) (also branded as the Grand Seiko WR-5100K; Grand Seiko Co. Ltd., Hiroshima, Japan) based on the open-field refractometry principle in refractive measurements of preschool children and to determine its ability to eliminate accommodation adequately.

Methods: The refractive results of 114 preschool children who presented to the ophthalmology outpatient department for screening were evaluated. The measurements were obtained before and after cycloplegia with the Shin-Nippon NVision-K 5001 autorefractometer and after cycloplegia with retinoscopy, which is the gold standard. The results underwent vectorial transformation to produce the spherical equivalent (M) and two Jackson cross-cylinder (J0 and J45) values. All results were then subjected to statistical analysis. The difference between the measurements was evaluated with repeated measures analysis of variance.

Results: Included in the study were 106 preschool children (51 boys and 55 girls). The mean age was 5.3 ± 0.9 years (range: 3 to 6 years). Although statistically significantly more myopic results were obtained with non-cycloplegic measurements using the Shin-Nippon NVision-K 5001 autorefractometer (P < .001), no difference was observed in cylindrical values (P > .05). Cycloplegic J0 measurements were significantly lower (P < .001), but no difference was found between J45 values before and after cycloplegia (P > .05).

Conclusions: The Shin-Nippon NVision-K 5001/Grand Seiko WR-5100K open-field autorefractometer seems to be inadequate in eliminating accommodation in childhood. Measurements under cycloplegia continue to be the best method to ensure accurate results. [J Pediatr Ophthalmol Strabismus. 2017;54(5):311-318.].