September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Age, eye dominance, and phoria cause errors in measurement of objective refractions
Author Affiliations & Notes
  • Yukari Tsuneyoshi
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Hidemasa Torii
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Yasuyo Nishi
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Yuki Hidaka
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Sachiko Masui
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Kazuo Tsubota
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Kazuno Negishi
    Ophthalmology, Keio University School of medicine, Tokyo, Japan
  • Footnotes
    Commercial Relationships   Yukari Tsuneyoshi, None; Hidemasa Torii, None; Yasuyo Nishi, None; Yuki Hidaka, None; Sachiko Masui, None; Kazuo Tsubota, None; Kazuno Negishi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6238. doi:
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      Yukari Tsuneyoshi, Hidemasa Torii, Yasuyo Nishi, Yuki Hidaka, Sachiko Masui, Kazuo Tsubota, Kazuno Negishi; Age, eye dominance, and phoria cause errors in measurement of objective refractions. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6238.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Some binocular open-field autorefractors have been developed to avoid errors resulting from measurement using conventional monocular autorefractors under unnatural conditions. There may be smaller errors in older subjects with less accommodation amplitude (AA) because the instrumental myopia is smaller in older subjects. This study tested the hypothesis that the difference between binocular and monocular objective refractions is less in older subjects with less AA than in younger subjects.

Methods : Fifty-eight healthy eyes of 29 subjects aged 25 to 60 years (mean, 38.4 ± 10.0 [standard deviation] years) were enrolled prospectively. Objective monocular refractions (MR) were measured with the Nidek Auto Ref/Keratometer ARK-730A (-2.20 ± 2.09 diopters [D]). Objective binocular open-field refractions (BR) (-1.69 ± 2.07 D) and objective AA were measured with the Grand Seiko Auto Ref/Keratometer WAM-5500. Ocular dominance was determined by the hole-in-the-card test. The presence and magnitude of far and near (30 cm) phoria were evaluated using the cover test and alternating cover test using a prism bar.

Results : The BR was significantly more hyperopic than the MR by 0.51 ± 0.33 D (P < 0.001). The results of subtracting the MR from the BR were significantly negatively correlated with age (r = -0.231, P = 0.04) and positively correlated with AA (r = 0.223, P = 0.046). When dominant eyes (DE) and non-dominant eyes (NDE) were assessed separately, the correlation between the BR minus the MR and age remained significant in the DE (r = -0.372, P = 0.02) but not in the NDE (r = -0.102, P = 0.30). Far and near phoria were present in one and 10 subjects, respectively. The results of the BR minus MR were significantly correlated with the amount of near phoria (r =0.403, P = 0.02) in the NDE, although there was no correlation in the DE (r =0.110, P = 0.29).

Conclusions : Our results are consistent with our hypothesis that the difference between binocular and monocular objective refractions is less in older subjects with less AA. The ocular dominance and position in addition to the AA should be considered when dealing with data measured by monocular instruments.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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