Abstract
Objective: To evaluate the performance of two subjective refraction measurement algorithms by comparing the refraction values, visual acuity, and the time taken by the algorithms with the standard subjective refraction (SSR). Methods: The SSR and two semi-automated algorithm-based subjective refraction (SR1 and SR2) in-built in the Vision-R 800 phoropter were performed in 68 subjects. In SR1 and SR2, the subject’s responses were recorded in the algorithm which continuously modified the spherical and cylindrical component accordingly. The main difference between SR1 and SR2 is the use of an initial fogging step in SR1. Results: The average difference and agreement limits intervals in the spherical equivalent between each refraction method were smaller than 0.25 D, and 2.00 D, respectively. For the cylindrical components, the average difference was almost zero and the agreement limits interval was less than 0.50 D. The visual acuities were not significantly different among the methods. The times taken for SR1 and SR2 were significantly shorter, and SR2 was on average was three times faster than SSR. Conclusions: The refraction values and the visual acuity obtained with the standard subjective refraction and algorithm-based methods were similar on average. The algorithm-based methods were significantly faster than the standard method.
Highlights
Our vision is determined by both optical and neural factors, and subjective refraction considers these factors to determine the optimal optical correction
The times taken for each subjective refraction methods were significantly different (p < 0.05)
We evaluated the performance of two algorithm-based methods by comparing the outcome with the manual standard method
Summary
Our vision is determined by both optical and neural factors, and subjective refraction considers these factors to determine the optimal optical correction. The objective refraction only considers the optical factors. The subjective refraction which takes into account both optical and neural factors is used to determine the final optical correction. The subjective refraction is often described as the gold-standard method though the procedure varies widely. The methods used to perform subjective refraction mainly vary in terms of steps used to determine best sphere, usage of duochrome, the technique used to determine cylinder and binocular balance. It has been recommended that subjective refraction can be used as a gold standard when new refractive procedures are assessed if the procedure for subjective refraction is fully described [1]
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