As one of the co-authors of this study I would like to clarify the high prevalence of myopia in our group.The main reason most probably is non-cycloplegic refraction which was done in most of the children. Cycloplegic ref. was done only in some suspected cases depending upon clinicians decision. The criteria was -0.50DS which can be easily obtained in small children as they often tend to accommodate a little bit. This could raise a defining criteria of myopia in preschool children while considering non-cycloplegic refraction.
Article Screening Preschool Children for Visual Disorders: A Pilot Study
In the methods section of your publication you mentioned that retinoscopy was performed only in selected cases under cycloplegia. When you do retinoscopy in children without cycloplegia many of your probands will accommodate and therefore you measure a false myopic refration.
Hi Heinrich,
I agree with your views. But in cases where cycloplegic refraction is not feasible should we consider the criteria in prescribing preschool children as more recent studies have found that non-cycloplegic refraction is equally sensitive in detecting clinically significant refractive errors. Please find the attached reference: http://www.iovs.org/content/55/3/1378.full?sid=90cc09c5-d78b-4520-a327-b4092b7e60cf
Thank you.
As A clinician my practice is to do a cyclo refraction at first or second visit on all low vision children. This gives me a baseline and working on the basis that hyperopes rarely become more hyperopic and that myopes will become more myopic, I track progress on review and recyclo only when evidence suggests that change other than that expected, occurs.
J
I agree with you Andrew . And also, in my opinion we need to have separate cut-off criteria for non-cycloplegic refractive errors.
Thanks Nabin, it would be good to collate some guidance from a series or professional body standards etc. Good project for a masters student or undergrad final year project.
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