Hand-Held Autorefractor Delivers High Patient Satisfaction

Smiling man with goatee wearing blue shirt looks through diopter machine to obtain new prescription
Patients rated prescriptions created using an autorefractor similar to those created with subjective refraction.

Prescriptions created using a  portable wavefront autorefractor delivered similar patient satisfaction scores as a subjective refraction, according to study results published in Ophthalmology. The technology could provide refractions for the large patient population who have limited access to medical care.

A team of researchers conducted a randomized crossover clinical trial of patients between the ages of 18 and 40 years, presenting with refractive errors to assess whether patients preferred spectacle prescriptions using the autorefractor or standard subjective refraction. 

Patients underwent subjective autorefraction, then autorefraction using a monocular version of the portable device. Eyeglasses were prepared on each refraction approach by an independent optician who was masked to the refraction approach and patients were randomly assigned to use either the autorefraction eyeglasses or subjective refraction eyeglasses first for a week, followed by the use of the other in the second week. 

The primary outcome measured the difference in proportions of patients who preferred eyeglasses issues using autorefraction vs subjective refraction, which was measured at the end of the second follow-up visit. Secondary outcomes included the level of agreement of the eyeglass prescription using autorefraction and subjective refraction and the variation in patient experience of wearing the 2 pairs of eyeglasses. 

A total of 400 patients (mean age, 28.4 years; 68.8% women) were included in the analysis. The mean visual acuity of this patient population was 0.53 logMAR. Subjective refraction and autorefraction were found to be strongly correlated (r=0.97; P <.001) and had an average difference of -0.07 D.

Of the cohort, 99 patients were lost to follow-up and 301 participants were included in the final analysis. Of the remaining participants, 50.5% preferred eyeglasses prescribed by subjective refraction and 49.5% preferred eyeglasses prescribed by autorefraction (P =.86). Additionally, no differences were observed between patient groups for demographic or vision characteristics (P >.05 for all). 

“The lack of patient preference for one approach over the other lends strong support to wider use of the [portable autorefractor] in resource-limited settings and possibly in other locations as well,” according to investigators. 

The majority of the patient population included participants with low myopia. “Future research should also attempt to capture less common refractive errors,” the investigators suggest. 

Disclosure: Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. This research was supported by PlenOptika, Inc. Please see the original reference for a full list of authors’ disclosures.  


Joseph S, Varadaraj V, Dave SR, et al. Investigation of the accuracy of a low-cost, portable, autorefractor to provide well-tolerated eyeglass prescriptions: a randomized crossover trial. Ophthalmol. Published online June 7, 2021. doi:10.1016/j.ophtha.2021.05.030