Abstract
Advancements in clinical measurement of refractive errors should lead to faster and more reliable measurements of such errors. The study investigated different aspects of advancements and the agreement of the spherocylindrical prescriptions obtained with an objective method of measurement (“Aberrometry” (AR)) and two methods of subjective refinements (“Wavefront Refraction” (WR) and “Standard Refraction” (StdR)). One hundred adults aged 20–78 years participated in the course of the study. Bland–Altman analysis of the right eye measurement of the spherocylindrical refractive error (M) identified mean differences (±95% limits of agreement) between the different types of measurements of +0.36 D (±0.76 D) for WR vs. AR (t-test: p < 0.001), +0.35 D (± 0.84 D) for StdR vs. AR (t-test: p < 0.001), and 0.0 D (± 0.65 D) for StdR vs. WR (t-test: p < 0.001). Monocular visual acuity was 0.0 logMAR in 96% of the tested eyes, when refractive errors were corrected with measurements from AR, indicating that only small differences between the different types of prescriptions are present.
Highlights
Subjective refraction is a key measure in the optometric and ophthalmic field
Since this measurement is by its definition subjective, the repeatability and the precision of the measurement within the same and between different examiner can vary and was reported to have a 95% limit of agreement (LoA) between ±0.27 and ±0.75 D for the spherical equivalent refractive error [2,3,4,5]
In case of the i.Profiler plus from ZEISS, the percentages of agreement for differences in the spherical refractive error of ±0.50 D were higher and calculated to be minimum 76%, when Standard Refraction was compared to the Autorefraction
Summary
The combination of the most positive lenses (spherical and astigmatic) that provides the highest visual acuity is determined in this process that follows a predefined workflow [1]. Since this measurement is by its definition subjective, the repeatability and the precision of the measurement within the same and between different examiner can vary and was reported to have a 95% limit of agreement (LoA) between ±0.27 and ±0.75 D for the spherical equivalent refractive error [2,3,4,5]. Limits of agreement for the wavefront measurement of the spherical error were found to be between ±0.2 (for a pupil diameter of 4.0 and 6.7 mm) [10] and ±0.55 D [11] (for pupil diameters of 4.0 and 6.0 mm) and did not differ between several measurements, without the use of an cycloplegic agent to block accommodation [11]
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