AIM:To compare the results of computer optometry and manifest refraction after mydriasis and prescription for refractive error in juveniles and explore the emphasis and notes of juvenile optometry.

METHODS: Totally 334 ametropic eyes of juveniles(including 212 myopic eyes and 122 hypermetropic eyes)were examined with computer optometry and manifest refraction after mydriasis. The manifest refraction was done again after the pupil recovered to obtain the prescription for refractive error. The results of computer optometry and manifest refraction after mydriasis and prescriptions for refractive error were compared and analyzed retrospectively.

RESULTS: When comparing computer optometry and manifest refraction after mydriasis, the differences of spherical power and cylindrical axis in general group, the differences of spherical power, cylindrical power and axis in myopia group and cylindrical axis in hyperopia group were all statistically significant(P<0.05). The differences of spherical power and cylindrical axis between computer optometry and manifest refraction after mydriasis and prescriptions in general and hyperopia group were statistically significant(P<0.05). The spherical power of computer optometry and manifest refraction after mydriasis in hyperopia group was greater than that of prescription and there was statistically significant difference in cylindrical power between manifest refraction after mydriasis and prescription(P<0.05). In myopia group the differences in spherical power, cylindrical power and axis between computer optometry after mydriasis and prescription were statistically significant(P<0.05)and the differences in cylindrical power and axis between manifest refraction after mydriasis and prescription were statistically significant(P<0.05). The Bland-Altman analysis in three groups showed the good consistency of spherical and cylindrical power between computer optometry and manifest refraction after mydriasis and that the differences between them were acceptable clinically. It also showed the poor consistency of cylindrical axis between them. The Bland-Altman analysis in general and hyperopia groups showed the poor consistency of spherical power and cylindrical axis and the good consistency of cylindrical power between computer optometry and manifest refraction after mydriasis and prescription. In myopia group the spherical and cylindrical power between computer optometry and manifest refraction after mydriasis and prescription revealed good consistency and the cylindrical axis presented poor consistency.

CONCLUSION: The results of computer optometry and manifest refraction after mydriasis cannot be used as prescription. There was statistically significant difference between computer optometry and manifest refraction after mydriasis, but the spherical and cylindrical power between them revealed good consistency clinically. The cylindrical axis between computer optometry and manifest refraction after mydriasis presented poor consistency and so did the cylindrical axis between them and prescription. In conclusion, the cylindrical axis should be paid much attention to in optometry and glasses taking.