Automated Subjective Device Obtains Accurate Hyperopic Refractive Measurements

An automated subjective device, which consists of a binocular open field aberrometer combined with a phoropter attached to a digital tablet, may be useful for determining refractive error in individuals with hyperopia when used under cycloplegic conditions, according to a study published in the Journal of Optometry. 

Researchers enrolled 42 participants (76% women, mean age, 18.2 years) with hyperopia (spherical equivalent refraction [SER], 0.50-6.00 diopters [D]) in the cross-sectional investigation and performed subjective refraction, under cycloplegic and non cycloplegic conditions, using both the automated subjective device and tradition subjective refraction. The team compared spherical equivalent, cylindrical components (J0 and J45), and corrected distance visual acuity (CDVA) values obtained using both methods. 

The automated subjective device demonstrated the ability to obtain similar spherical equivalent (P =.34), J0 and J45 values (P =.41 and P >.99, respectively), and corrected distance visual acuity measurements compared with traditional subjective refraction (P >.99) during cycloplegia. 

However, the automated subjective device measured significantly less hyperopia compared with traditional subjective refraction when used under non cycloplegic conditions (mean difference, −0.31; 95% CI, 0.85 to −1.47 D; P =.009). The device improved distance-corrected visual acuity (mean difference, 0.4 logarithm of the minimum angle of resolution [logMAR]; P =.01) and performed the subjective assessment in significantly less time (3 minutes, 57 seconds vs 7 minutes, 5 seconds; P <.001) while not under cycloplegia compared with traditional subjective refraction, the report shows.    

“The main advantage of automated subjective refraction is saving time in clinical practice due to autorefraction and subjective adjustment being incorporated into a single instrument, allowing the automation of all refraction steps,” according to the study authors. 

Study limitations include the use of only 1 cycloplegic agent (cyclopentolate) and failure to consider inter examiner variability by using more than 1 clinician to obtain measurements with each device.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.