A Comparison of Autorefraction and Subjective Refraction in an Academic Optometry Clinic.

Content Provider	Europe PMC
Author	Kemchoknatee, Parinee Sunlakaviset, Pornlada Khieokhoen, Nattawat Srisombut, Thansit Tangon, Duanghathai
Editor	Muacevic, Alexander Adler, John R
Copyright Year	2023
Abstract	Background Refractive error is the most common cause of decreased visual acuity. Refractive measurement in adults consists of cycloplegic (objective) and manifest (subjective) refraction. Although the effectiveness of autorefraction is a crucial factor, there needs to be more information on its accuracy and precision on each autorefractor compared with subjective measurement in Thai patients. Objective To compare the accuracy and precision of the two autorefractors' findings in Rajavithi Hospital, OptoChek Plus, and TOMEY Auto Refractometer RC-5000, with each other and with those of the subjective method. Materials & methods An observational study was conducted at the Ophthalmology clinic in Rajavithi Hospital from March 1, 2021, to March 31, 2022. All subjects were tested using the two autorefractors (OptoChek Plus and TOMEY Auto Refractometer RC-5000) and subjective refraction. One eye per subject was included in the study. Results Forty-eight patients (48 eyes) were enrolled in the study. The difference between spherical powers obtained by OptoChek and subjective refraction was not significantly different; however, there was a significant difference between those calculated by Tomey and the subjective method (p=0.77, p=0.04 respectively). The variations between cylindrical powers arrived at by the two autorefraction techniques and those calculated by the subjective method were significantly different (OptoChek and Tomey p-=0.01, p-value<0.001, respectively). In addition, 95% of the limit of agreement (95% of LOA) was low in the cylindrical measurement of each autorefractor compared with subjective refraction. (84.61%, 86.36%, respectively). No statistically significant difference between the spherical equivalent calculated by the two autorefractors and that of subjective refraction was observed in the present study (OptoChek: p-value=0.26 and Tomey: p-value=0.77). Conclusions There was a clinically significant difference between the cylindrical power calculated by the two autorefractors and those obtained from subjective refraction. Patients with high astigmatism should be monitored closely when measured by autorefractors, as there can be a slightly lower agreement between objective and subjective refraction.
Journal	Cureus
Volume Number	15
DOI	10.7759/cureus.37448
PubMed Central reference number	PMC10174683
Issue Number	4
PubMed reference number	37182059
e-ISSN	21688184
Language	English
Publisher	Cureus
Publisher Date	2023-04-11
Publisher Place	Palo Alto (CA)
Access Restriction	Open
Subject Keyword	spherical equivalent cylindrical power spherical power refraction subjective refraction autorefraction autorefractor
Content Type	Text
Resource Type	Article
Subject	Medicine