Utility of an open field Shack-Hartmann aberrometer for measurement of refractive error in infants and young children

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Abstract

Purpose To assess the utility of an open-field Shack-Hartmann aberrometer for measurement of refractive error without cycloplegia in infants and young children. Method Data included 2698 subject encounters with Native American infants and children aged 6 months to <8 years. We attempted right eye measurements without cycloplegia using the pediatric wavefront evaluator (PeWE) on all participants while they viewed near (50 cm) and distant (2 m) fixation targets. Cycloplegic autorefraction (Rmax [Nikon Retinomax K-plus2]) measurements were obtained for children aged ≥3 years. Results The success rates of noncycloplegic PeWE measurement for near (70%) and distant targets (56%) significantly improved with age. Significant differences in mean spherical equivalent (M) across near versus distant fixation target conditions were consistent with the difference in accommodative demand. Differences in astigmatism measurements for near versus distant target conditions were not clinically significant. Noncycloplegic PeWE and cycloplegic Rmax measurements of M and astigmatism were strongly correlated. Mean noncycloplegic PeWE M was significantly more myopic or less hyperopic and astigmatism measurements tended to be greater in magnitude compared with cycloplegic Rmax. Conclusions The PeWE tended to overestimate myopia and underestimate hyperopia when cycloplegia was not used. The PeWE is useful for measuring accommodation and astigmatism.

Original languageEnglish (US)
Pages (from-to)494-500
Number of pages7
JournalJournal of AAPOS
Volume17
Issue number5
DOIs
StatePublished - Oct 2013

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Refractive Errors
Astigmatism
Pediatrics
Mydriatics
Hyperopia
North American Indians
Myopia

ASJC Scopus subject areas

  • Ophthalmology
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Utility of an open field Shack-Hartmann aberrometer for measurement of refractive error in infants and young children",
abstract = "Purpose To assess the utility of an open-field Shack-Hartmann aberrometer for measurement of refractive error without cycloplegia in infants and young children. Method Data included 2698 subject encounters with Native American infants and children aged 6 months to <8 years. We attempted right eye measurements without cycloplegia using the pediatric wavefront evaluator (PeWE) on all participants while they viewed near (50 cm) and distant (2 m) fixation targets. Cycloplegic autorefraction (Rmax [Nikon Retinomax K-plus2]) measurements were obtained for children aged ≥3 years. Results The success rates of noncycloplegic PeWE measurement for near (70{\%}) and distant targets (56{\%}) significantly improved with age. Significant differences in mean spherical equivalent (M) across near versus distant fixation target conditions were consistent with the difference in accommodative demand. Differences in astigmatism measurements for near versus distant target conditions were not clinically significant. Noncycloplegic PeWE and cycloplegic Rmax measurements of M and astigmatism were strongly correlated. Mean noncycloplegic PeWE M was significantly more myopic or less hyperopic and astigmatism measurements tended to be greater in magnitude compared with cycloplegic Rmax. Conclusions The PeWE tended to overestimate myopia and underestimate hyperopia when cycloplegia was not used. The PeWE is useful for measuring accommodation and astigmatism.",
author = "Harvey, {Erin M} and Miller, {Joseph M} and Schwiegerling, {James T}",
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T1 - Utility of an open field Shack-Hartmann aberrometer for measurement of refractive error in infants and young children

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AU - Miller, Joseph M

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N2 - Purpose To assess the utility of an open-field Shack-Hartmann aberrometer for measurement of refractive error without cycloplegia in infants and young children. Method Data included 2698 subject encounters with Native American infants and children aged 6 months to <8 years. We attempted right eye measurements without cycloplegia using the pediatric wavefront evaluator (PeWE) on all participants while they viewed near (50 cm) and distant (2 m) fixation targets. Cycloplegic autorefraction (Rmax [Nikon Retinomax K-plus2]) measurements were obtained for children aged ≥3 years. Results The success rates of noncycloplegic PeWE measurement for near (70%) and distant targets (56%) significantly improved with age. Significant differences in mean spherical equivalent (M) across near versus distant fixation target conditions were consistent with the difference in accommodative demand. Differences in astigmatism measurements for near versus distant target conditions were not clinically significant. Noncycloplegic PeWE and cycloplegic Rmax measurements of M and astigmatism were strongly correlated. Mean noncycloplegic PeWE M was significantly more myopic or less hyperopic and astigmatism measurements tended to be greater in magnitude compared with cycloplegic Rmax. Conclusions The PeWE tended to overestimate myopia and underestimate hyperopia when cycloplegia was not used. The PeWE is useful for measuring accommodation and astigmatism.

AB - Purpose To assess the utility of an open-field Shack-Hartmann aberrometer for measurement of refractive error without cycloplegia in infants and young children. Method Data included 2698 subject encounters with Native American infants and children aged 6 months to <8 years. We attempted right eye measurements without cycloplegia using the pediatric wavefront evaluator (PeWE) on all participants while they viewed near (50 cm) and distant (2 m) fixation targets. Cycloplegic autorefraction (Rmax [Nikon Retinomax K-plus2]) measurements were obtained for children aged ≥3 years. Results The success rates of noncycloplegic PeWE measurement for near (70%) and distant targets (56%) significantly improved with age. Significant differences in mean spherical equivalent (M) across near versus distant fixation target conditions were consistent with the difference in accommodative demand. Differences in astigmatism measurements for near versus distant target conditions were not clinically significant. Noncycloplegic PeWE and cycloplegic Rmax measurements of M and astigmatism were strongly correlated. Mean noncycloplegic PeWE M was significantly more myopic or less hyperopic and astigmatism measurements tended to be greater in magnitude compared with cycloplegic Rmax. Conclusions The PeWE tended to overestimate myopia and underestimate hyperopia when cycloplegia was not used. The PeWE is useful for measuring accommodation and astigmatism.

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