Analysis for Clinical Refraction by Optometrists

Abstract

A total 136 cases of refraction examinations performed between the year 2015 and 2018 by korean optometrists were analyzed based on 16 items to assess the errors observed during these examinations. The results of the analysis showed that history were not administered in 50.7% of the cases. Further, dominant eye testing was not performed in 72.8% of cases; uncorrected visual acuity testing in 86.8%; refractive power measurements of the current prescription in 54.4%; corrected visual acuity testing with the current prescription in 91.9%; subjective refraction test using a phoropter in 45.6%; fogging before refraction testing in 72.1%; maximal visual acuity testing in 80.9%; fogging before astigmatism testing in 72.8%; astigmatic fan chart testing in 49.3%; astigmatic refining testing in 39.0%; maintenance of meridian balance during astigmatic refining testing in 66.2%; binocular balance testing in 29.4%; and spherical end-point testing in 12.5%. The most preferred test for measuring binocular balance was the alternating cover test, which was performed in 27.4% of the cases, and the most preferred method to the measure end-point of refraction was the maximum plus to maximum visual acuity (MPMVA) procedure, performed in 43.4% of the cases. In 45.0% of the cases, optometrists performed the binocular balance test without the dominant eye test, and in 26.5% of cases, they conducted the astigmatic fan chart test without fogging. In 27.2% of the cases, astigmatic refining tests were conducted without the maintenance of the meridian balance; 23.5% of the binocular end-point refraction measurements were conducted without the binocular balance test, and 35.3% of astigmatic tests were conducted with unchanged autorefractometer (AR) values. Such inaccuracies during the examination process could lead to inability in obtaining a complete correction of the refractive errors in the participants and cause various deviations in the refraction test-based binocular visual function findings.