AIM:To compare the differences and correlation of Spot vision screener and autorefractor in measuring preschool children refractive status under natural pupil conditions.

METHODS: A cross-sectional study was conducted from October to November 2021. A total of 311 children from a senior kindergarten in Jiangyin city were randomly selected and underwent refraction test using both Spot vision screener and autorefractor without cycloplegia. The astigmatism was decomposed into J₀ and J₄₅ by the Thibos vector analysis. The differences in spherical equivalence(SE), sphere, cylinder, J₀ and J₄₅ measured by these two devices were compared using Wilcoxon signed rank test. Spearman analysis was employed to analyze the correlation.

RESULTS:One child was excluded from the initial 311 children due to sphere power <-7.50 D, exceeding the detection range of the Spot vision screener(-7.50 to +7.50 D). A total of 310 children were ultimately included in this study, and the data of right eye of each child were selected. There was no statistically significant difference between the SE measured by the Spot vision screener and the autorefractor(P=0.598), while the difference in sphere, cylinder, J₀, and J₄₅ was statistically significant(all P<0.001). Measurements from these two devices had a positive correlation \〖SE(r_s=0.350, P<0.001), sphere(r_s=0.403, P<0.001), cylinder(r_s=0.545, P<0.001), J₀ (r_s=0.672, P<0.001), J₄₅ (r_s=0.439, P<0.001)\〗.

CONCLUSION:The results of Spot vision screener and autorefractor cannot be replaced by each other, and different referral indicators should be set for these two devices in vision screening.