6-48月龄婴幼儿Spot屈光度异常结果分析

目的：分析6-48月龄婴幼儿Spot屈光异常情况,为婴幼儿屈光不正矫正及弱视早期防治提供依据。

方法：对6-48月龄婴幼儿使用Spot双目视力筛查仪进行自然状况下验光,根据Spot屈光筛查仪4岁以下儿童转诊标准,收集屈光异常婴幼儿临床资料; 使用睫状肌麻痹剂视网膜检影验光,并对验光结果进行统计分析。

结果：根据转诊标准共收集Spot屈光度异常婴幼儿168例336眼。其中远视及散光异常占比高,分别为38.4%和28.6%,而近视占比低(12.2%)。168例Spot屈光度异常婴幼儿中,屈光参差(≥1.00 D)共90例,其中散光性屈光参差41例(45.6%)、远视性屈光参差33例(36.7%),近视性屈光参差16例(17.8%)占比最少。共109例Spot屈光度异常婴幼儿完成睫状肌麻痹剂视网膜检影验光。对其Spot屈光度与睫状肌麻痹后检影验光结果差异及相关性分析结果显示,两者散光度差异为0.34±0.64 D(P<0.001),远视度差异为-2.10±1.27 D(P<0.001),近视度差异为-0.43±0.91 D(P=0.023); 虽然二者结果存在统计学差异,但二者散光度、远视度及近视度均呈正相关(r=0.694、0.762、0.909)。

结论：6-48月龄婴幼儿Spot屈光异常主要以散光、远视异常和屈光参差为主,近视异常较少; 对Spot筛查异常者应进一步睫状肌麻痹剂视网膜检影验光,给予配镜矫正,有效防止婴幼儿屈光性弱视。     

盐酸环喷托酯滴眼液和复方托品卡胺睫状肌麻痹效果比较

目的:了解盐酸环喷托酯滴眼液和复方托品卡胺滴眼液在散瞳验光中麻痹睫状肌的临床效果,客观地对其评价以指导临床工作。 方法:随机抽取2010-12/2011-03期间的60例120眼屈光不正（近视和远视各占50%）患者,年龄12～40岁,利用国产复方托品卡胺滴眼液滴眼散瞳先后对其进行散瞳4次, 45min以后,对其进行检影验光,并利用综合验光仪测定其残余调节量,第2d用盐酸环喷托酯眼液进行复验。 结果:远视组盐酸环喷托酯滴眼液和复方托品卡胺两者验光结果差异较大（P＜0.01）;近视组两者验光差异较小（P＜0.05）,但是仍然具有统计学差异。 结论:临床上对于屈光不正患者的屈光检查,复方托品卡胺滴眼液是一种有效的睫状肌麻痹剂,但因注意到其麻痹睫状肌及放松调节的有限性,特别在远视患者应灵活结合其他放松调节如盐酸环喷托酯眼液的方法获取最终的配镜处方。     

学龄儿童远视眼戴镜矫正对发生近视的影响

目的:探讨儿童远视眼与发生近视的相关性。方法:经常规扩瞳验光后诊断+0.75～+4.00D的远视眼儿童122例244眼,分戴镜治疗组和非戴镜对照组;每3mo复查常瞳的裸眼、戴镜视力和显性屈光状态1次,每年常规扩瞳验光1次;应用复方托吡咔胺滴眼液作睫状肌麻痹剂,滴眼共6次,滴最后1次40min后检影验光;连续3a观察屈光状态的演变。结果:戴镜组7,8,9岁的平均远视度分别是+1.66D,+1.71D和+1.65D,非戴镜组7,8,9岁的平均远视度分别是+1.28D,+1.08D和+1.10D;观察满3a时,戴镜组年均下降远视度分别是+0.26D,+0.26D和+0.31D,发生近视分别有2眼(4.8%),1眼(2.5%)和4眼(10.0%);非戴镜组年均下降远视度分别是+0.58D,+0.59D和+0.66D,发生近视分别有18眼(42.9%),24眼(60.0%)和33眼(82.5%)。两组相比,有非常显著性的差异(P<0.01)。结论:戴镜矫治远视眼儿童的远视屈光度比不戴镜矫治的下降慢,近视的发生率比不戴镜矫治的明显低。     

不同睫状肌麻痹剂对儿童调节力及屈光状态的影响

目的 找出美多丽P滴眼液、罗米滴眼液最大睫状肌麻痹时间,对比美多丽P滴眼液、罗米滴眼液、1%阿托品眼膏最大睫状肌麻痹时的剩余调节力,并分析3种药物对屈光不正检测的影响.为眼科临床上合理应用睫状肌麻痹剂提供一定的实验依据.方法 对4～16岁儿童75例、147只眼进行检查,均未曾配戴眼镜,未曾屈光治疗,其裸眼或矫正视力均可达1.0,并除外其他眼病及影响调节的全身病.按3种药物分3组,对其睫状肌麻痹前后不同时间点分别进行手持自动电脑验光仪客观验光,视网膜检影验光,在综合验光仪上主观验光,在其上用移近法测量调节力及剩余调节力.结果 (1)最大睫状肌麻痹时间罗米为60min,美多丽P为30min,次日均可以正常阅读.(2)最大睫状肌麻痹时平均剩余调节力:1%阿托品组(2.0440±0.95484)D,罗米组(2.2214±0.6952)D,美多丽P组(2.6656±0.9999)D.两独立样本t检验前两组无显著差异,美多丽P组与前两组差异显著,尤其近视时剩余调节力偏大.(3)三组剩余调节力均与屈光状态及年龄无关.(4)1%阿托品、罗米、美多丽P三组中每组药物最大睫状肌麻痹后,综合验光仪验光、视网膜检影结果无差别,都能达到主、客观验光结果的一致性.结论 罗米滴眼液、美多丽P滴眼液在临床上可以作为近视及远视验光的有效睫状肌麻痹剂.     

青少年2628只视力正常眼的屈光状态

目的　探讨视力正常青少年的屈光状态。方法　采用 1%阿托品麻痹睫状肌后检影验光 ,测定 6～ 18岁青少年 2 62 8只视力正常眼的屈光度。屈光类型按检影实际结果 ,本文以 <± 0 2 5D为正视 ,≥± 0 2 5D分别为远视类型或近视类型。结果　本组轻度远视占 91 2 1% ,≥± 3 2 5D占1 71% ;近视占 2 89% ;正视仅占 4 19%。各年龄组屈光度峰值都不在正视处 ,6～ 12岁组之间峰值有规律地向近视侧偏移。三种屈光类型比例的变化在 6～ 12岁组与年龄相关 ,12～ 18岁组变化与年龄增长的相关性无统计学意义。结论　青少年的正常屈光状态为轻度远视。几何光学的“正视眼”与生物医学角度的屈光“正常眼”是两个不同概念 ,应予以区分     

盐酸环喷托酯和阿托品对远视儿童睫状肌麻痹效果的比较

目的:比较盐酸环喷托酯与阿托品对远视儿童睫状肌麻痹效果,以评估盐酸环喷托酯的临床使用价值。方法:对96例192眼远视儿童进行观察,先用盐酸环喷托酯滴眼液,后用阿托品眼膏,分析比较两种药物睫状肌麻痹后的验光结果和观察药物的不良反应。结果:两组睫状肌麻痹后的验光结果差异无显著性(P>0.05)。盐酸环喷托酯组未见明显药物不良反应,低于阿托品组(12.5%)。结论:盐酸环喷托酯是一种强效、快速且安全的睫状肌麻痹剂,值得临床推广应用,尤其适合远视儿童的睫状肌麻痹验光检查。     

调节性近视的临床探讨

调节性近视可分正视性、远视性及近视性,也称混合性近视。调节性近视,看远时调节仍未放松,远视力低于1.0,小孔接受凹透镜。如经睫状肌麻痹剂阿托品扩瞳后,由于睫状肌松弛,原为正视者,视力可达正常,原为轻度远视或轻度近视者,用扩瞳检影中和的度数能矫正     

昆明市婴幼儿屈光状态的调查

目的　调查和了解婴幼儿的屈光状态,并予以合理矫正,以期尽早治疗和预防弱视、斜视。方法　采用随机整群抽样方法,对1146例（2291只眼）生后1个月至3岁的婴幼儿用托品酰胺眼液麻痹睫状肌后行视网膜检影验光,并对其结果进行统计学分析。结果　正视89只眼（3.88%）;远视2139只眼（93.37%）;近视38只眼（1.66%）;散光560只眼（24.44%）;其中混合散光25只眼（1.09%）;各类型屈光不正均以轻度为主,中、高度屈光不正97只眼（4.23%）;屈光参差34例(2.97%);斜视7例（11只眼,0.48%)。随年龄增长,远视度逐渐减低,散光眼数逐渐减少（χ     

NIDEK手持自动电脑验光仪在儿童屈光不正中的应用

目的:了解手持自动电脑验光仪的准确性及在儿童屈光不正中的应用价值。方法:对27例4～16岁儿童用10g/L阿托品眼膏3次/d,连续3d,睫状肌麻痹前后,分别进行视网膜检影、NIDEKAUTOREF/KERATOMEARK-30手持自动电脑验光仪验光和综合验光仪主观验光。结果:睫状肌麻痹后,手持自动电脑验光仪与视网膜检影结果间相关系数为0.980,差值均数±标准差为-0.37±0.52,95%可信区间为-0.51～-0.23;手持自动电脑验光仪与综合验光仪主观验光结果间相关系数为0.982,差值均数±标准差为-0.37±0.49,95%可信区间为-0.51～-0.24,以上两组配对t检验均P=0.000,均差异显著。表明在95%的测量中,结果差异均在0.50D以内。不同屈光状态下,在95%可信区间内,屈光度相差范围为远视<0.75D,近视<0.50D。结果均为手持自动电脑验光仪比视网膜检影、综合验光仪主观验光偏负值。睫状肌麻痹前由于调节的影响3种检查结果相差较大,远视结果相差比近视结果相差大。结论:睫状肌麻痹后,手持自动电脑验光仪验光和视网膜检影、综合验光仪主观验光有极高的一致性,在儿童屈光不正检查中是一种很有价值的、方便的、可靠的屈光检查工具。     

儿童远视和近视眼睫状肌麻痹前后各屈光成分的变化

目的通过测量比较儿童远视和近视眼睫状肌麻痹前后各屈光成分的变化,探讨调节对其屈光成分的影响。方法对520例3～12岁儿童使用1%阿托品散瞳验光,睫状肌麻痹前后均采用光学相干生物测量仪（Zeiss IOL Master）测量眼轴长度、角膜屈光力（K1、K2）、前房深度。对其中远视646眼、近视221眼的睫状肌麻痹前后各屈光成分测量值进行统计对照分析。结果①儿童远视眼睫状肌麻痹后眼轴变短（P=0.01）,角膜屈光力变小（K1P=0.01;K2P=0.04）,前房深度加深（P=0.00）。②儿童近视眼睫状肌麻痹后前房深度加深（P=0.00）,眼轴长度、角膜屈光力无变化。结论儿童远视眼睫状肌麻痹后眼轴变短,角膜屈光力变小,前房加深;儿童近视眼睫状肌麻痹后前房加深,而眼轴长度、角膜屈光力无变化。     

广州市荔湾区学龄儿童屈光不正患病率的现况调查

目的 探讨广州市荔湾区5～15岁儿童的屈光不正患病率情况.方法 采用人群为基础的横断面调查方法.在2002年10月至2003年1月期间,中山大学巾山眼科中心对广州市荔湾区居住的全部5～15岁儿童,通过随机整群抽样和逐户登记确定样本与受检对象,在71个学校和19个社区检查点进行检查,眼部榆查包括视力、眼球运动、散瞳检影验光、自动验光、外眼、眼前段、屈光间质及眼底检查.屈光不正与儿童的年龄、性别及家长教育程度的关系采用多元回归模型进行分析.结果 在登记的5053名儿童中,实际检查4364人,受检率为86.4%.以等效球镜-0.50 D以下作为界定,近视的患病率为35.1%(95%可信区间:33.2%～36.9%),患病率从5岁的3.3%增加到15岁时的73.1%(根据检影验光);女性儿童具有较高的患病率,调整比数比为1.29(95%可信区间:1.11～1.51);以等效球镜+2.00 D以上作为界定,远视患病率为5.8%(95%可信区间:5.3%～6.3%),从5岁时16.7%减少到15岁时低于1.0%.散光(柱镜屈光度≥0.75 D)的患病率在视网膜检影法为33.6%,而在自动验光法为42.7%.Logistie回归模型显示近视与年龄(OR=1.52,95%可信区间:1.48～1.56)、女性(OR=1.29,95%可信区间:1.11～1.51)和父母教育程度(OR=1.22,95%可信区间:1.05～1.42)有关.结论 广州市荔湾区学龄儿童具有较高的近视患病率,近视已经成为重要的公共卫生问题,提高儿童屈光矫正的覆盖率和质量足当前的主要挑战.     

Prevalence rate of myopia in schoolchildren in rural Mongolia.

PURPOSE: The prevalence of myopia among some young Asian populations has been reported to be increasing to near epidemic proportions. Mongolia is an emerging Asian economy with limited ophthalmic resources. The purpose of this study was to define a level of myopia for school-aged children in rural Mongolia. METHODS: A total of 1057 schoolchildren, aged between 7 and 17 years, were examined in two remote, rural suums (districts) of Mongolia: one situated in the western aimag (province) of Khovd and the other in the central steppe's aimag of Zavkhan. The examination included retinoscopy, subjective refraction, best-corrected visual acuity, and direct ophthalmoscopy. RESULTS: The total prevalence of myopia (more than -0.5 D spherical equivalent) was 5.8% (95% confidence intervals [CIs], 4.4-7.2%). Female students exhibited a significantly higher prevalence of myopia in comparison to male students: 8.3% (95% CIs, 6.0-10.6%) compared with 3.1%, respectively (95% CIs, 1.6-4.6%): p < 0.001). For those with myopia, the median level of myopia for both genders was -0.75 D spherical equivalent (SE) and ranged from -0.50 to -28.00 D SE in girls and from -0.50 to -6.50 D SE in boys. CONCLUSIONS: To the authors' knowledge, this is the first study to report a level of myopia for schoolchildren in Mongolia. The prevalence rate is low in comparison to reported studies for other Far Eastern countries.     

3～12岁儿童眼轴长度、晶状体屈光力与屈光不正的关系

目的：探讨3～12岁儿童屈光参数发育特点,分析其与屈光不正的相关性。方法：描述性研究。共纳入2017年12月至2018年12月在重庆医科大学附属儿童医院眼科门诊就诊的3～12岁儿童600例 （1 200眼）,通过睫状肌麻痹检影验光及光学生物量仪（IOL-Master）获得等效球镜度（SE）、眼轴长度、角膜屈光力、前房深度,并计算晶状体屈光力。按年龄分成3组,分别为3～6岁组,7～9岁组和10～12岁组。按SE分成5组,分别为远视组、正视组、轻度近视组、中度近视组和高度近视组。 采用独立样本t检验、单因素方差分析及线性回归分析年龄、屈光与各屈光参数的关系。结果：3～6岁组,7～9岁组和10～12岁组SE（F=131.5,P<0.001）及晶状体屈光力（F=276.4,P<0.001）随年龄增长逐渐变小,眼轴长度（F=235.02,P<0.001）、前房深度（F=228.7,P<0.001）随年龄增长逐渐增大,角膜曲率（F=0.01,P=0.66）变化稳定。3组SE与眼轴长度呈负相关（r=-0.80、-0.85、-0.81,均P<0.001）,与晶状体屈光力呈正相关（r=0.98、0.92、0.91,均P<0.001）。轻度近视组,眼轴长度及晶状体屈光力与SE呈正相关性（r=0.545、0.601,P<0.001）;高度近视组眼轴长度及晶状体屈光力与SE呈正相关性（r=0.675、0.784,P<0.001[1]）。矫正年龄和性别后,眼轴长度解释SE 73.6%的变异,晶状体屈光力可解释SE 86.5%的变异。结论：眼轴长度与晶状体屈光力是影响屈光发育和近视发展的主要因素。     

Prevalence of myopia and hyperopia in a population of Polish schoolchildren

PURPOSE: The aim of this study was to determine the prevalence of myopia and hyperopia in a population of Polish schoolchildren. METHODS: A total of 4422 students were examined (2107 boys and 2315 girls, aged 6-18 years, mean age 11.1, S.D. 3.5). The examination included retinoscopy under cycloplegia induced with 1% tropicamide. Myopia was defined as a spherical equivalent (SE) of at least -0.5 dioptres (D), and hyperopia as a SE of at least +1.0 D. Data analysis was performed using Spearman's rank correlation coefficients and chi-squared test; p-values of <0.05 were considered statistically significant. RESULTS: It was observed that 13.3% of Polish students in the age group ranging from 6 to 18 years were myopic while 13.1% of students were hyperopic. Furthermore, a positive correlation was found between the prevalence of myopia and age (p < 0.001) and a negative correlation between prevalence of hyperopia and age (p < 0.001). It was observed that the prevalence of myopia increases substantially between 7 and 8 years of age (p < 0.01). Moreover, it was determined that with age the average refractive error among schoolchildren becomes more myopic (p < 0.001). CONCLUSIONS: The occurrence, degree and progress of myopia and hyperopia in Poland is similar to that in other European countries with a predominantly Caucasian population.     

眼挫伤后一过性近视临床分析

目的探讨眼挫伤后一过性近视的发生机制。方法收集眼挫伤后一过性近视26例(26眼),并对其临床特征和发病机制进行分析。结果小瞳检影验光发现所有外伤眼均存在近视,其中96%的外伤眼表现为轻、中度近视。睫状麻痹剂散瞳后验光发现所有外伤眼的近视度数均显著减轻。经合适的凹透镜矫正后所有外伤眼视力均可达1.0。对症治疗后4周内所有外伤眼的视力均恢复至≥1.0。结论当眼挫伤眼部检查未见明显阳性体征,而又主诉视力下降时,应进行屈光检查,以确定有无眼挫伤后一过性近视的存在。外伤性一过性近视病程短,对药物治疗反应好,且预后佳。     

Structural sequelae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes

Aim:

The aim was to study the structural sequelae and refractive outcome after laser treatment for Type 1 prethreshold retinopathy of prematurity (ROP) in Asian Indian eyes.

Materials and Methods:

A retrospective chart review of infants with Type 1 prethreshold ROP (defined according to the Early Treatment for Retinopathy of Prematurity study) undergoing laser treatment at a tertiary center between January 2004 and December 2008 was done. The 1-year outcome of infants was analyzed.

Results:

Sixty-nine eyes of 36 infants were included. The mean birth weight was 1121.69 ± 254.81 g and the gestational age was 28.99 ± 2.03 weeks. Sixty-five eyes (94.2%) had zone 2 and 4 (5.8%) had zone 1 disease. Forty-four (63.77%) eyes had stage 2 ROP with plus disease and 25 (36.23%) eyes had prethreshold (fewer than five contiguous or eight cumulative clock hours) stage 3 ROP with plus disease. None of the eyes developed retinal structural sequelae. On cycloplegic retinoscopy, 59.4% eyes had nonsignificant hyperopia [spherical equivalent (SE) ≤ 4 D], 14.5% eyes had no refractive error (SE 0 D), 24.7% eyes had low myopia (SE < 5 D), and 1.4% eyes had high myopia (SE > 5.0 D). Eyes developing myopia were associated with a greater number of clock hours of ROP, greater number of laser spots used, and a longer time to disease regression. Two infants (5.6%) had esotropia and one (2.8%) had exotropia.

Conclusion:

Asian Indian infants treated for Type 1 prethreshold ROP did not develop retinal structural sequelae. Myopia was seen in nearly one-fourth of the eyes.The risk factors for myopia were a greater number of clock hours of ROP, greater number of laser spots, and a longer time to regression of ROP.     

无视网膜病变早产儿生后早期的屈光状态研究

目的 了解早产儿生后早期的屈光发育.方法 横断面研究.收集生后4～6周进行早产儿视网膜病变筛查的无视网膜病变的早产儿253例,按矫正胎龄进行分组:A组(22只眼),矫正胎龄≤34周;B组(52只眼),矫正胎龄>34周且≤36周;C组(126只眼),矫正胎龄>36周且≤38周;D组(144只眼),矫正胎龄>38周且≤40周;E组(136只眼),矫正胎龄>40周且≤42周,F组(26只眼),矫正胎龄>42周且≤44周.行睫状肌麻痹检影验光确定屈光状态.其中38例在矫正胎龄40～44周时的屈光与同龄足月对照组比较.定量资料为非正态分布,使用Mann-Whitney U检验,相关性使用Spearman相关分析及回归分析.定性资料使用X2检验.结果 早产儿随出生体重的增加、孕龄和检查时矫正胎龄的增大,等效球镜远视程度增大.出生体重是等效球镜的显著影响因素.近视发生率14.43%,并随着矫正胎龄的增加而下降.散光发生率10.28%,各年龄组间差异无统计学意义.散光度中位数+1.00 DC,随着矫正胎龄的增加而增大,与出生孕龄和体重无关.散光轴向中位数90°,与矫正胎龄、出生孕龄和体重均无关.矫正胎龄40～44周的早产儿和足月儿比较,除等效球镜差异有统计学意义,前者有更大的近视趋势外,近视发生率、散光发生率、散光度、散光轴向的差异均无统计学意义.结论 早产儿屈光状态随发育向远视方向发展,但到矫正胎龄40～44周时仍较足月儿有较大的近视趋势,其潜在机制及随后的屈光发育有待进一步研究.(中华眼科杂志,2009,45:607-611)     

重庆酉阳县土家族青少年屈光不正及相关因素的流行病学调查

目的：了解重庆市酉阳县土家族青少年人群屈光不正的患病率及其影响因素。方法：横断面调查研究。采用分层整群抽样的方法,对重庆市酉阳县城镇和乡村各2所中学（初中和高中）的土家族青少年共973例进行眼科检查。通过电脑自动验光及1%环戊通滴眼液扩瞳后检影验光获得青少年的屈光状态,以调查问卷方式了解并分析近视发生的相关因素,包括户外活动时间、父母屈光状态等。采用Pearson卡方检验以及Pearson和Spearman相关性分析对数据进行处理。结果：近视（等效球镜度≤-0.50 D）、远视（等效球镜度≥+0.50 D）以及散光（柱镜度≤-0.50 D）的患病率分别为66.3%（645例）,17.5%（170例）和15.1%（147例）。高度近视检出25例,占总检出人数的2.6%。男生近视患病率（59.8%）显著低于女生（72.5%） （ χ 2 =17.53,P < 0.001）。城镇青少年近视患病率（77.9%）显著高于乡村青少年（51.6%） （ χ 2 =74.12,P < 0.001）。随着年龄增长,近视患病率逐渐升高（ χ 2 =84.70,P < 0.001）,远视患病率逐渐降低（ χ 2 =78.30,P < 0.001）。近视的土家族青少年中,父母双方均存在（ χ 2 =10.85,P=0.001）或单方存在（ χ 2 =56.01,P < 0.001）近视的概率显著高于非近视青少年。青少年户外活动时间与屈光状态呈显著正相关（r 2 =0.781,P < 0.001）。结论：重庆市酉阳县土家族青少年女性近视患病率较高;城镇青少年近视患病率高于乡村;近视发病与父母近视和户外活动时间相关。     

中山市2006～2007年中小学生近视调查分析

目的 探讨中山市中小学近视情况及相关因素.方法 采用随机整群抽样调查方法.在2006年至2007年期间,对中山市中小学通过随机抽样在市区和镇区6所学校(包括市区3所镇区3所)进行调查,采用问卷调查和散瞳验光检查其屈光度.各年级间及镇区与市区之间学生近视发病率采用卡方检验,近视率与用眼时间用相关系数分析.结果 此次调查对象共9379人,近视5443人,近视率58.03%,近视率从小学一年级8.04%上升到高三86.68%,市区和镇区小学近视率差异无统计学意义(P＞0.05),初中阶段市区近视率明显高于镇区(P＜0.01),高中阶段高三毕业班近视率明显高于高一高二非毕业班(P＜0.05镇区P＜0.001市区).此次调查中眼保健操对预防近视加深无明显作用(P0.05),每天看书总时间、一次持续看书时间、看课外书时间与近视发生呈正相关,相关系数分别为0.995、0.992、0.999.结论 中山市中小学生近视率较高,近视率与用眼时间密切相关.如何适当减轻学生的学习负担是预防近视的关键.     

Evaluation of the accuracy of estimation retinoscopy.

BACKGROUND: Some children are unable to cooperate for retinoscopy because they object strongly to the placement of lenses close to their faces. For these children, it would be ideal to obtain an accurate estimate of refractive error without using lenses. Techniques of estimation retinoscopy include sliding the sleeve of the Copeland retinoscope downward or moving closer to the patient until neutrality is achieved. The purpose of this study was to evaluate the accuracy of estimation techniques by comparing results to standard retinoscopy with loose lenses in cooperative children. METHODS: A Copeland retinoscope was calibrated using a schematic eye and loose lenses. A scale was created adjacent to the sleeve of the retinoscope which allowed an estimate of refractive error based on the position of the top of the sleeve. Estimation retinoscopy followed by standard retinoscopy with loose lenses was done on 100 eyes of 50 children after cycloplegia. RESULTS: Estimation of spherical equivalent for myopia less than 4 D and hyperopia less than 2 D correlated strongly with results obtained by standard retinoscopy with loose lenses (r = 0.87). Estimation retinoscopy had a sensitivity of 88%, specificity of 67%, positive-predictive value of 58%, and negative-predictive value of 92% in the detection of amblyogenic refractive errors. CONCLUSIONS: Estimation retinoscopy has very good accuracy for low levels of myopia, hyperopia, and astigmatism. Techniques of estimation may be useful in excluding amblyogenic refractive errors, particularly in children who object to loose lenses held close to them.