SynthesisOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2022
Systematic review and meta-analysis on the agreement of non-cycloplegic and cycloplegic refraction in children.
Synthesis in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Myopia prevalence in Malaysian children: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute.European journal of ophthalmology · 2024Guideline
- Systematic review and meta-analysis on the agreement of non-cycloplegic and cycloplegic refraction in children.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2022Pooled it
- Effects of tropicamide and compound tropicamide eye drops on ocular biological parameters and choroid thickness in children.BMC ophthalmology · 2025Trial
- Machine Learning-Based Prediction of Cycloplegic Refraction Using the Eyerobo Vision Screener: Design-A Cross-Sectional Comparative Device Study.Ophthalmology and therapy · 2026Article
- Is cycloplegic refraction necessary in adults? Insights from a comparative refraction study.Indian journal of ophthalmology · 2026Article
- Vision screening of Greenlandic children evaluating efficacy, coverage and future directions.Acta ophthalmologica · 2026Article
- Assessing the reliability of non-cycloplegic refraction in children: a machine learning approach based on non-cycloplegic parameters.Frontiers in public health · 2026Article
- Associated factors of myopia in a Portuguese sample of adolescents: Parental history and school-related lifestyle.PloS one · 2026Article
- Age-Related Clinical Agreement Between Noncycloplegic Autorefraction and Subjective Refraction: A Power-Vector Analysis.Journal of ophthalmology · 2026Article
- Comparative Analysis of the Efficacy of 1% Tropicamide and 1% Cyclopentolate Eye Drops for Cycloplegic Refraction in Indonesian Paediatric Population.The British and Irish orthoptic journal · 2026Article
- Visual profiling and vision screening of preschool children in Greenland.International journal of circumpolar health · 2025Article
- Investigation of Natural Refractive Changes in Young Hyperopic Children Using Atropine Cycloplegic Refraction.Cureus · 2025Article
- Combined and interaction effects of outdoor and reading time on myopia onset: evidence from over 210 000 schoolchildren in China.Journal of global health · 2025Article
- Health-related quality of life and its associated factors among high school students with myopia in China.BMC public health · 2025Article
- Myopia Prediction Using Machine Learning: An External Validation Study.Vision (Basel, Switzerland) · 2025Article
- Multiple trajectories of life style indicators and their links to myopia in the middle school students: A five-year cohort study.Scientific reports · 2025Article
- Comparing Close-Field and Open-Field Autorefractometry and Subjective Refraction.Journal of clinical medicine · 2025Article
- Influence of dynamic changes of ocular biometric parameters on new-onset myopia in Chinese children: a 4-year cohort study.Scientific reports · 2025Article
- Myopic-Net: Deep Learning-Based Direct Identification of Myopia Onset and Progression.Translational vision science & technology · 2025Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the diagnostic agreement of non-cycloplegic and cycloplegic refraction in children.
methodThe study methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases were searched for comparative studies exploring refraction performed on children under non-cycloplegic and cycloplegic conditions. There was no restriction on the year of publication; however, only publications in the English language were eligible. Inclusion criteria consisted of children aged ≤12 years, any degree or type of refractive error, either sex and no ocular or binocular co-morbidities. The QUADAS-2 tool was used to evaluate the risk of bias. Meta-analysis was conducted to synthesise data from all included studies. Subgroup and sensitivity analyses were undertaken for those studies with a risk of bias.
resultsTen studies consisting of 2724 participants were eligible and included in the meta-analysis. The test for overall effect was not significant when comparing non-cycloplegic Plusoptix and cycloplegic autorefractors (Z = 0.34, p = 0.74). The pooled mean difference (MD) was -0.08 D (95% CI -0.54 D, +0.38 D) with a prediction interval of -1.72 D to +1.56 D. At less than 0.25 D, this indicates marginal overestimation of myopia and underestimation of hyperopia under non-cycloplegic conditions. When comparing non-cycloplegic autorefraction with a Retinomax and Canon autorefractor to cycloplegic refraction, a significant difference was found (Z = 9.79, p < 0.001) and (Z = 4.61, p < 0.001), respectively. DISCUSSION: Non-cycloplegic Plusoptix is the most useful autorefractor for estimating refractive error in young children with low to moderate levels of hyperopia. Results also suggest that cycloplegic refraction must remain the test of choice when measuring refractive error ≤12 years of age. There were insufficient data to explore possible reasons for heterogeneity. Further research is needed to investigate the agreement between non-cycloplegic and cycloplegic refraction in relation to the type and level of refractive error at different ages.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.