June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Clinical validation of a novel wavefront autorefractor in a base hospital and vision center in rural India
Author Affiliations & Notes
  • Nicholas J. Durr
    Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
    PlenOptika, Inc. , Boston, Massachusetts, United States
  • Shivang R. Dave
    PlenOptika, Inc. , Boston, Massachusetts, United States
  • Daryl Lim
    PlenOptika, Inc. , Boston, Massachusetts, United States
  • Ramakrishnan Mahadevan
    Aurolab, Madurai, Tamil Nadu, India
  • Sriram Ravilla
    Aurolab, Madurai, Tamil Nadu, India
  • Sanil Joseph
    Aravind Eye Care System, Madurai, Tamil Nadu, India
  • Thulasiraj D. Ravilla
    Aravind Eye Care System, Madurai, Tamil Nadu, India
    Aurolab, Madurai, Tamil Nadu, India
  • Eduardo Lage
    PlenOptika, Inc. , Boston, Massachusetts, United States
    Department of Biochemistry, Universidad Autonoma de Madrid, Medical School, Madrid, Spain
  • Footnotes
    Commercial Relationships   Nicholas Durr, MIT (P), PlenOptika (I); Shivang Dave, MIT (P), PlenOptika (E), PlenOptika (I); Daryl Lim, MIT (P), PlenOptika (E), PlenOptika (I); Ramakrishnan Mahadevan, Aurolab (E); Sriram Ravilla, Aurolab (E); Sanil Joseph, None; Thulasiraj Ravilla, Aurolab (E); Eduardo Lage, MIT (P), PlenOptika (I), PlenOptika (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1139. doi:
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      Nicholas J. Durr, Shivang R. Dave, Daryl Lim, Ramakrishnan Mahadevan, Sriram Ravilla, Sanil Joseph, Thulasiraj D. Ravilla, Eduardo Lage; Clinical validation of a novel wavefront autorefractor in a base hospital and vision center in rural India. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1139.

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

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Abstract

Purpose : To assess the best-corrected visual acuity (VA) and patient preference for eyeglasses prescribed by a novel autorefractor and an experienced refractionist in south India.

Methods : Participants were recruited from patients scheduled for a general refraction at Aravind Eye Hospital (base hospital, N=506; and satellite vision center, N=202). Patients were prescribed eyeglasses via subjective refraction (LSR) by an ophthalmic technician with over four years of refraction experience. Consenting patients that were within the range of the autorefractor (-6D to +10D) were enrolled in the study. Participants were then prescribed eyeglasses with an autorefractor (LAR) that was an alpha prototype of the QuickSee wavefront aberrometer. The QuickSee is handheld, binocular, open-view, intended to be low-cost, and was operated by a technician with no formal eye care training. The VA and prescription preferences for trial lenses set to LSR and LAR were evaluated by a refractionist blinded to the prescription source. The right-eye VA for each patient was converted to LogMar values and analyzed with a paired t-test. Prescription preferences were determined with a survey.

Results : The mean age of participants was 35 ± 13 years (range: 15-70). Of the 708 participants, 220 had presbyopia, 75 had an immature cataract, 21 had conjunctivitis, and 1 had keratoconus. Mean VA was 0.29 ± 0.36, -0.04 ± 0.11, and -0.01 ± -0.15 LogMar units before correction, with LSR, and with LAR, respectively. VA was significantly better after correction from both prescription methods (p < 0.01). VA from LSR was also significantly better than LAR (p < 0.01). A total of 47%, 91%, and 85% of patients had 20/20 vision or better, before correction, with LSR, and with LAR, respectively. Survey results showed 25% of participants had no preference of eyeglasses, 42% preferred LSR, and 33% preferred LAR.

Conclusions : Our study shows a small benefit to eyeglasses prescribed by subjective refraction versus a novel autorefractor. Participants using eyeglasses prescribed by the autorefractor achieved a VA that was only approximately one letter worse than using eyeglasses prescribed by a refractionist. More than half of the participants either had no preference or preferred eyeglasses prescribed by the autorefractor. However, the required training to perform autorefraction is considerably shorter compared to subjective refraction.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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