Automatic Refractometry

Over the past few decades, many innovative devices and techniques have been developed that favor eye health. Refractometry (optometry) is a technique in ophthalmology that aids in the estimation of refractive error. In this article, we will discuss automatic refractometry, an investigation performed through an optical device, an automatic refractometer.

What conditions are diagnosed through automatic refractometry?

As the name suggests, an automatic refractometry is performed to estimate refractive errors. Other tools for measuring refractive errors like retinoscopes and Snellen’s vision charts are also available. While these investigations can determine refractive errors to a greater extent, autorefractors have been one of the best tools for conducting preliminary examinations.

Refractive errors are one of the most common eye conditions occurring in younger adults and the elderly. They are usually classified into four different types: 

  • Myopia (near-sightedness): When the object at the distance seems blurry but the near object looks clear. 
  • Hyperopia (far-sightedness): When the object at the near distance seems blurry but the far object looks clear.
  • Astigmatism: When there is distorted vision due to abnormal curvature of the eyes.
  • Presbyopia: When there is gradual loss of ability to focus on nearby objects, associated with old age.

An automatic refractometer will allow your doctor to write prescriptions for glasses and contact lenses. Various sophisticated forms of autorefractors are now available that have increased the arena of possible diagnosis with the help of the device. One of them includes an inbuilt keratometer that measures the curvature of the cornea for a better assessment of astigmatism.

Apart from using automatic refractometry as a diagnostic tool, it can be used as a screening tool as well. Before the subjective determination of refractive error, automatic refractometry is usually conducted when a patient visits an eye clinic. It is used as a part of preliminary checkups before and after any eye surgery. It is also used widely for research purposes as a handy and effective tool.

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What Can You Expect While Undergoing Automatic Refractometry?

If you experience blurred vision or distorted images, you must visit your eye doctor. Your doctor may examine you with an automatic refractometer. You can recognize autorefractors in your ophthalmologist’s office easily. Those are typically mounted on a table.

1. The patient is asked to sit in front of the device opposite to your examiner. 
2. The patient needs to place their head on the device where their chin is supported by a chin rest and forehead is supported with the forehead rest designed on the device. The examiner can adjust the height and alignment of your eye level through a controlling knob present on the examiner’s side. The examiner examines one eye at a time, aligning the lateral canthus of your eye to the marking present on the autorefractor.
3. Once the patient is comfortable and the alignment is set, the patient will be asked to focus on the image emitted at the center of the vision. Usually, three measurements are recorded for each eye to calculate the estimated refractive error. The examiner may move the device in multiple directions, either forward and backward or side to side, while performing the test. Patients can blink the eye in between the investigation, and alert the examiner in case of any inconvenience.  
What Are the Pros of Automatic Refractometry?

Automatic refractors have made the process of eye examination easier and more accurate. While there are other investigations and tools available to measure refractive errors, an automatic refractometer provides some good benefits over others. Some of them are:

Easy to use
Less likely of performer bias and error
Accurate and reliable data
Speeds up the process of examination
Objective data reducing patients bias
Can be linked to Electronic Medical Record (EMR) software
Requires less patient cooperation

What Are the Possible Setbacks of Automatic Refractometry?

Although the new versions of automatic refractometers are designed to address many of the disadvantages seen in older versions, there are still a few concerns that need to be addressed in future devices. The most common disadvantages of automatic refractometers are as follows:

  • Challenging to use in the pediatric population due to less compliance
  • Uncomfortable for some patients with short stature if the investigation is performed when sitting
  • The autorefractor may not show reliable reading despite several attempts, which may be due to other underlying pathologies like poor fixation, nystagmus, cataracts, amblyopia, small pupils, pseudophakia, and more
  • For someone with photosensitivity, it may be difficult to focus on the target light from the autorefractors
  • Lower accuracy in older populations with cataracts or age-related macular degeneration

The Takeaway

One of the most common conditions a patient visits their ophthalmologist with is refractive errors. Automatic refractometer is a diagnostic as well as screening investigation that allows objective measurements of refractive errors.

While it uses infrared light-emitting diodes to cast a light passing through the patient’s eyes, its effect on the eye is negligible and, thus, is hazard-free. It provides easy, accurate, and reliable reading. Automatic refractometer is a widely used optic tool to write prescriptions for glasses and contact lenses.

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