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

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.

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