Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul;88(7):830-6.
doi: 10.1097/OPX.0b013e3182192658.

Comparison of the Retinomax and Palm-AR Auto-Refractors: a pilot study

Vision in Preschoolers (VIP) Study Group  1 ; Elise Ciner, Ashanti Carter, Gui-Shuang Ying, Maureen Maguire, Marjean Taylor Kulp
Collaborators, Affiliations

Comparison of the Retinomax and Palm-AR Auto-Refractors: a pilot study

Vision in Preschoolers (VIP) Study Group et al. Optom Vis Sci. 2011 Jul.

Abstract

Purpose: To compare the performance of two handheld auto-refractors, the Retinomax and the Palm-Automatic Refractometer (Palm-AR), for detecting significant vision disorders in pre-school children.

Methods: Children attending Philadelphia PreKindergarten Head Start were screened with the Retinomax and Palm-AR and underwent a gold standard eye examination. The results of cycloplegic retinoscopy, cover testing, and visual acuity were used to classify children as having normal vision or one of four conditions: amblyopia, strabismus, significant refractive error, and reduced visual acuity. Pass/fail criteria for each instrument were selected to maximize overall sensitivity (with specificity set at 90% and at 94%) for detecting targeted disorders. Comparisons of sensitivities between the auto-refractors were performed using the exact McNemar test.

Results: Testability was >99% for both instruments. Test time was similar for the two instruments (median 2 min; p=0.10). At 90% specificity, the sensitivity for detection of one or more targeted conditions was 74% for the Palm-AR and 78% for the Retinomax. At 94% specificity, the sensitivity for detection of one or more targeted conditions was 66% for both the Palm-AR and the Retinomax. At 90% specificity, the sensitivity for detecting significant refractive error was 84% for both auto-refractors, and at 94% specificity, the sensitivity was 76% for the Palm AR and 75% for the Retinomax. There were high correlations between the instruments for sphere (r=0.85) and cylinder (r=0.88) power. The mean difference between instruments was -0.13 diopters (D) (95% limit of agreement: -2.28 to 2.02) for sphere, and -0.15 D (95% limit of agreement: -0.89 to 0.59) for cylinder.

Conclusions: In this pilot study, the Retinomax and Palm-AR appear comparable with respect to testability, sensitivity, and specificity. There was strong agreement in readings of sphere and cylinder indicating that they may perform similarly in a screening setting.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bland-Altman plot and 95% limit of agreement for sphere between Retinomax and Palm-AR. X-axis shows the mean sphere from Retinomax and Palm-AR for each eye. Y-axis shows the difference of sphere between Retinomax and Palm-AR (Retinomax – Palm-AR) for each eye. The middle dashed line shows the mean difference of sphere between Retinomax and Palm-AR, and the dashed lines above and below the middle dashed line are its 95% limits of agreement.
Figure 2
Figure 2
Bland-Altman plot and 95% limit of agreement for cylinder between Retinomax and Palm-AR. X-axis shows the mean cylinder from Retinomax and Palm-AR for each eye. Y-axis shows the difference of cylinder between Retinomax and Palm-AR (Retinomax – PalmAR) for each eye. The middle dashed line shows the mean difference of cylinder between Retinomax and Palm-AR, and the dashed lines above and below the middle dashed line are its 95% limits of agreement.
See this image and copyright information in PMC

References

    1. U.S. Public Health Service. Vision screening in children. Am Fam Physician. 1994;50:587–90. - PubMed
    1. Moore B. Eye Care for Infants and Young Children. Boston: Butterworth-Heinemann; 1997.
    1. Ciner EB, Schmidt PP, Orel-Bixler D, Dobson V, Maguire M, Cyert L, Moore B, Schultz J. Vision screening of preschool children: evaluating the past, looking toward the future. Optom Vis Sci. 1998;75:571–84. - PubMed
    1. American Optometric Association Consensus Panel on Pediatric Eye and Vision Examination. Pediatric Eye and Vision Examinations. 2. St. Louis: American Optometric Association; 2002. - PubMed
    1. American Academy of Ophthalmology Preferred Practice Patterns Pediatric Ophthalmology Panel. Preferred Practice Pattern. San Francisco: American Academy of Ophthalmology; 2002. Pediatric Eye Evaluations.

Publication types