Spot screen versus cycloplegic refraction
Reviewed by Fiona Rowe

This study compared the spherical, cylindrical and spherical equivalent values obtained by the Spot screener before and after induction of cycloplegia with the values of cycloplegic refraction to explore the application value of the Spot screener in refractive error screening for preschool children. The study recruited 457 children aged three to six years. Refractions of seven children were outside the measurement range of the Spot screener (>7.50D). Cycloplegic refraction for these children was 10 or 8D. Data were analysed for the remaining 450 children. Mean age was 4.57 ±1.01 years; 80 were aged 36-48 months and 370 were aged >48 months. There were 53.56% males. The authors found the Spot screener underestimated sphere by 1.5D and spherical equivalent by 1.56D, and overestimated JO by 0.09D versus cycloplegic refraction values. The Spot screener underestimated J45 by 0.02D which was not significant. For low hypermetropia ≤3D, underestimations increased with greater cycloplegic hypermetropia and this was greater for moderate to high hypermetropia. The Spot screener was efficient in detecting anisometropia. However, for detection of hypermetropia, the authors recommend an adjustment of the Spot referral criteria.

Spot refractive screening with or without maximum atropine cycloplegia in preschool Chinese children.
Liu X, Feng J, Wang L, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2021;58:146-53.