Accuracy of the cycloplegic vision screener V100 and desktop autorefractometer compared to retinoscopy in children: A comparative study with literature findings

Abstract

Purpose: To evaluate the cycloplegic accuracy of the Vision Screener V100 (VS) and a desktop autorefractometer (TAR) in comparison with cycloplegic retinoscopy (CR) in children, and to compare the findings with current literature. Methods: This prospective observational study included 50 pediatric patients (100 eyes) with a mean age of 9.8 +/- 1.7 years. Cycloplegic measurements were obtained using the VS, TAR, and CR. Agreement between methods was analyzed using intraclass correlation coefficients (ICC) and Bland-Altman plots. Differences in spherical and cylindrical values were specifically assessed. Results: TAR showed excellent agreement with CR, with ICC values above 0.95 for both spherical and cylindrical measurements. In contrast, the VS demonstrated moderate correlation for spherical values (ICC approximate to 0.82) and lower correlation for cylindrical values (ICC approximate to 0.60). Bland-Altman plots revealed that TAR had narrower limits of agreement with CR, particularly for astigmatism, whereas VS showed wider variability. These findings are consistent with previous reports indicating that non-cycloplegic photoscreening devices such as the VS tend to underestimate hyperopia and show reduced reliability in astigmatism assessment. Conclusion: TAR demonstrates excellent concordance with CR under cycloplegia, whereas the VS shows notably lower accuracy, especially in detecting astigmatism. Our results highlight the importance of cycloplegic evaluation for accurately assessing refractive errors in children.