Evaluation of the QuickSee portable autorefractor system in a pediatric population.

PURPOSE: To evaluate the QuickSee platform's ability to detect and measure refractive error relative to gold standard cycloplegic retinoscopy in a pediatric population in a clinical setting.

METHODS

Children 3-17 years of age underwent visual acuity screening, autorefraction by the QuickSee (QS) or QuickSee Free (QSF), and complete ophthalmic examination, including cycloplegic retinoscopy and refraction. The agreement of the results was evaluated by Bland-Altman plots. Sensitivity and specificity for detecting myopia, anisometropia, and astigmatism were calculated based on modified Orinda and AAPOS 2021 guidelines. The overall accuracy of detecting refractive error was analyzed with receiver operating characteristic curves.

RESULTS

A total of 157 children (mean age, 7.58 ± 2.62 years) underwent autorefraction by the QS system (QS/QSF), with a testability of 98.1%. Moderate-to-good agreement was seen in spherical equivalent (SE) and J0 between the QS system and retinoscopy. The slightly negative bias for SE and J0 suggests underestimation of QS measurements relative to retinoscopy. The area under curve was >0.9 for all definitions of hyperopia, myopia, and astigmatism. The QS system had sensitivities and specificities >0.8 for hyperopia, myopia, and astigmatism at all levels of refractive error considered. Using modified Orinda and AAPOS 2021 referral guidelines, the QS system demonstrated sensitivities of 89.2% and 94.4%, and specificities of 56.5% and 68.6%, respectively.

CONCLUSIONS

In our pediatric study cohort, the QS system effectively identified significant refractive error.