Assessment of refractive error by retinoscopy using fogging lens and cycloplegia in school aged children

Abstract

Purpose . To compare the refractive error measurements obtained through cycloplegic retinoscopy and fogging retinoscopy in school-aged children with myopia and hyperopia. Material and methods . A comparative cross-sectional study was conducted using a non-probability consecutive sampling technique among school-age children. The study analyzed 240 readings in children aged 6 to 15 years, with a mean age of 10.64 ± 2.82 years, including 45% males and 55% females. Visual acuity was measured using a LogMAR chart. Two retinoscopic procedures were performed to assess refractive error: fogging retinoscopy with a high-power plus lens and cycloplegic retinoscopy with 1% cyclopentolate and 0.5% tropicamide. The readings were entered into SPSS version 26.0 and compared after converting them into spherical equivalents (SE) using the Wilcoxon Signed-Rank Test, as preliminary analysis indicated that the data did not follow a normal distribution. Results . Descriptive statistics revealed minimal differences in SE measurements between fogging retinoscopy (mean = -0.41, SD = 5.63) in hyperopes and (mean = -4.8, SD = 3.65) in myopes and cycloplegic retinoscopy (mean = -0.47, SD = 5.64) in hyperopes and (mean = -4.9, SD = 3.69) in myopes. Inferential analysis showed no significant difference between the two methods in low to moderate hyperopes and myopes (p > 0.05) and a significant difference between the two methods in high hyperopes and myopes (p < 0.05). Conclusion . The present results confirm that fogging retinoscopy when performed with proper protocols by an experienced clinician, gives accurate results and can be a good alternative to cycloplegic retinoscopy.