Abstract
PurposeTo assess the performance of an open-view binocular handheld aberrometer (QuickSee) for diagnosing refractive errors in children.Methods123 school-age children (9.9 ± 3.3 years) with moderate refractive error underwent autorefraction (AR) with a standard desktop device and subjective refraction (SR), with or without cycloplegia to determine their eyeglass prescription. Measurements with QuickSee (QS) were taken in 62 of these patients without cycloplegia (NC), and in 61 under cycloplegia (C). Differences in refraction values (AR vs SR vs QS) as well as the visual acuity (VA) achieved by the patients with each method (QS vs SR) were used to evaluate the performance of the device in measuring refractive error.ResultsThe spherical equivalent refraction obtained by QS agreed within 0.5 D of the SR in 71% (NC) and 70% (C) of the cases. Agreement between the desktop autorefractor and SR for the same threshold was of 61% (NC) and 77% (C). VA resulting from QS refractions was equal to or better than that achieved by SR procedure in 77% (NC) and 74% (C) of the patients. Average improvement in VA with the QS refractions was of 8.6 and 13.4 optotypes for the NC and C groups respectively, while the SR procedure provided average improvements of 8.9 (NC) and 14.8 (C) optotypes.ConclusionsThe high level of agreement between QuickSee and subjective refraction together with the VA improvement achieved in both study groups using QuickSee refractions suggest that the device is a useful autorefraction tool for school-age children.
Highlights
Tackling visual impairment in childhood is a major global concern because it affects a child’s learning process, self-perception, life skills and overall development [1]
visual acuity (VA) resulting from QS refractions was equal to or better than that achieved by subjective refraction (SR) procedure in 77% (NC) and 74% (C) of the patients
The high level of agreement between QuickSee and subjective refraction together with the VA improvement achieved in both study groups using QuickSee refractions suggest that the device is a useful autorefraction tool for school-age children
Summary
Tackling visual impairment in childhood is a major global concern because it affects a child’s learning process, self-perception, life skills and overall development [1]. The World Health Organization reported in 2018 that nearly 1.3 billion people worldwide had vision impairment, the bulk of which are located in low- and middle-income countries [2] According to these sources, around 12.8 million children below the age of 15 years old [3] were visually impaired due to uncorrected refractive errors (UREs) [4], which remains the leading cause of visual disability among school-age children [4,5,6]. Even in developed countries with greater access to eyecare, significant prevalence of UREs among children have been found (e.g. 13.1% in the school district of Philadelphia [9], or 7.2% in Ireland [10]), and is expected to increase in the coming years [11] This may indicate that the problem is related to a lack of resources, and to eye care awareness
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