S.A. Erzurum, MD FACS Aylin Sarac

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Reliability of Aberrometry Versus Cycloplegic Retinoscopy in Prescribing Glasses to Undilated Child. S.A. Erzurum, MD FACS Aylin Sarac. Financial Interest. The authors have no financial interests in any of the topics discussed in this study. Purpose of Study. - PowerPoint PPT Presentation

Transcript of S.A. Erzurum, MD FACS Aylin Sarac

  • Reliability of Aberrometry Versus Cycloplegic Retinoscopy in Prescribing Glasses to Undilated Child S.A. Erzurum, MD FACSAylin Sarac

  • Financial Interest

    The authors have no financial interests in any of the topics discussed in this study.

  • Purpose of StudyRetinoscopy is a difficult skill for many eye care professionals.

    Children are a difficult subpopulation for eye care professional to refract.

    Inaccurate glass prescribing occurs for many children.

    Dilation necessary for accurate refraction but disliked by children and family.

  • Purpose of StudyFind a reliable method for non-specialized eye care providers to prescribe glasses for children.Reliable method should be easy and quick.

    Find method that eliminates/reduces need for dilating drops to check refraction.

  • MethodiZON Aberrometer was machine used for comparison to cycloplegic refraction.

    Images are taken before dilation.

    Child sits upon parents lap and multiple rapid images are obtained.

    Immediately upon taking image, analysis is provided of sphere, cylinder, axis, level of aberrations, and quality of image.

  • Example of poor image and unreliable readings.

    No measurements are provided for aberrations.

    Whatever prescription was captured is reported, but may not be reliable.

  • Example of right eye with poor image capture and left eye with excellent capture.

    Right eye results for refraction may not be reliable.

    Left eye results reliable.

  • MethodProspective consecutive series of 256 eyes in 128 pediatric patients involved in full exam.

    Age range of 3 to 18 years.

    iZON aberrometer images prior to dilation.

    Full eye exam with cycloplegic refraction.

    No patients were excluded, and all were examined by the same pediatric ophthalmologist.

  • Results CYCLOPLEGIC ABERROMETER (mean +/- SD)(mean +/- SD) Sphere 0.42 + 2.95 -0.05 + 2.16 Astigmatism 0.74 + 0.91 0.92 + 1.52 Spheric equiv 0.75 + 2.91 0.39 + 2.17

    Age (mean + SD) 8.1 + 3.2 years; Mode 7 years Range 3-18 years

    Female6248.4% Male6651.6%

  • Prevalence of Eye Disorders in Study Patients Prevalence of Eye DisordersNormal12046.9Esotropia3211.3Amblyopia2912.5Exotropia9 3.5Cerebral palsy/ 7 2.7 developmental delayCongenital nystagmus 4 1.6Cataracts3 1.2IDDM4 1.6Duanes3 1.2Bests1 0.4Coloboma1 0.4

  • Reliability of AberrometerOnly 45 eyes of 256 (17%)had an unreliable reading and were excluded from comparison.

    26 eyes of these 45 (64%)had ocular pathology which would have directed them to sub-specialized care.

    Immediately upon taking image, examiner is aware of reliability of image.

  • Results of Comparison between two MethodsComparison between aberrometer and cycloplegic results were made in each area of sphere, cylinder, and axis.

    In all categories, correlation was high between the two methods.

    Offset and slope of the best fit regression were calculated for each.

    All comparisons showed the slope was very close to 1.

  • Y cyclo sphere = 1.04 X izon sphere + 0.469Model ANOVA F = 1552.93, p < 0.001R = 0.934

  • Y cyclo SPHEQ = 1.019 X izon SPHEQ + 0.400Model ANOVA F = 718.782 p < 0.001R = 0.865

  • Y cyclo astig = 0.909 X izon astig 0.026Model ANOVA F = 766.735 p < 0.001R = 0.887

  • ConclusionsiZON aberrometer is a reliable method of refraction to assist practitioners uncomfortable with cycloplegic refraction in children.

    iZON aberrometer gives a reliable reading and a high correlation with cycloplegic refraction.

    Group of patients who showed higher unreliability by aberrometry measurements had a higher chance of ocular pathology.