April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
A method for patient self-refraction and on-site eyeglass assembly
Author Affiliations & Notes
  • Jennie Weinkle
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Cameron Pole
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Benjamin Thomas
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Joyce Schiffman
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Wei Shi
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Richard K Lee
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Footnotes
    Commercial Relationships Jennie Weinkle, None; Cameron Pole, None; Benjamin Thomas, None; Joyce Schiffman, None; Wei Shi, None; Richard Lee, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2713. doi:
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      Jennie Weinkle, Cameron Pole, Benjamin Thomas, Joyce Schiffman, Wei Shi, Richard K Lee; A method for patient self-refraction and on-site eyeglass assembly. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2713.

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

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Abstract
 
Purpose
 

Refractive error is a leading cause of visual impairment worldwide that can be largely avoided with non-invasive, inexpensive treatment with eyeglasses. Based on WHO data from 2012, approximately 285 million people experience visual impairment (visual acuity (VA) < 20/60 in the better eye); refractive error is the primary cause in 43% of cases. Yet, only 20% of people have access to refractive correction, with the greatest lack of access in the developing world. Access to refractive services could be improved with portable devices, teaching basic self-refraction techniques, and low-cost frames. The I-test Vision Screener is a manual self-refractor device used to measure refractive power. Our purpose is to evaluate patients’ ability to self-refract using the I-test compared to professional refraction, and compare the subsequent VA outcomes between ready-made spectacles and best-fit donated spectacles.

 
Methods
 

Twenty-three subjects were recruited during visits at the Free Spectacles Clinic at the Bascom Palmer Eye Institute, which provides used glasses that are best fit to a patient's professionally manifest refraction. After explanation of the study and demonstration of the I-test auto-refractor, consented subjects were asked to adjust the lens power for each eye until the clearest image was achieved. The spherical equivalents from the I-test were matched with pre-made spherical lenses inserted into ready-made frames. The patient's VA was measured and then compared to their VA wearing a pair of best-fit glasses from the Free Spectacles Clinic library of over 10,000 donated glasses.

 
Results
 

Initial data reveals that 88% of subject’s eyes were self-refracted within 1.0 Diopter of their spherical equivalent using the I-test. The VA using best-fit donated glasses was 0.10 LogMAR units better in the best eye (p=0.003) than with ready-made spectacles.The difference in LogMAR acuity between ready-made and glasses library in eyes with little or no astigmatism (Cylinder ≤0.5 D) is smaller than when all eyes are included: 0.07 LogMAR unit in the best eye (p=0.14) and 0.09 logMAR unit in the worse eye (p=0.35).

 
Conclusions
 

Preliminary results show that most patients are capable of using the I-test to measure their refractive error. The VA outcomes with ready-made spectacles give similar (within about 1 line) acuity results to the best-fit donated glasses.

 
 
Patient demonstrating use of the I-test.
 
Patient demonstrating use of the I-test.
 
 
Ready-made frames with pop-in lenses.
 
Ready-made frames with pop-in lenses.
 
Keywords: 754 visual acuity • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques • 676 refraction  
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