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$Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter$

Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter

Published on: September 16, 2025

Modifications made to the refractive result when prescribing spectacles.

Patricia K Hrynchak¹, Andrea M Mittelstaedt, Joel Harris

¹School of Optometry, University of Waterloo, Waterloo, Ontario, Canada. hrynchak@uwaterloo.ca

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|December 1, 2011

Summary

This summary is machine-generated.

Optometric practitioners frequently adjust subjective refractions when prescribing eyeglasses, with minor changes being common. Clinical judgment is crucial, as automated or subjective refraction alone is insufficient for accurate prescriptions.

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Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients

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Published on: March 29, 2022

Area of Science:

Optometry
Ophthalmology
Vision Science

Background:

Subjective refraction is a key step in determining a patient's eyeglass prescription.
Understanding how practitioners modify these results is essential for optimizing vision care.

Purpose of the Study:

To investigate the extent and nature of modifications made by optometric practitioners to subjective refractive outcomes when generating spectacle prescriptions.

Main Methods:

Analysis of 5001 patient records from the University of Waterloo's School of Optometry (January 2007-January 2008).
Comparison of entering prescription, subjective refraction, and final exiting prescription for patients aged 7 years and older.

Main Results:

Practitioners modified the refraction in at least one eye in 45% of cases.
Significant modifications (≥0.50 D or specific axis changes) occurred in 17% of cases.
Modifications generally moved prescriptions closer to the initial entering prescription, with exact duplication rare (0.7%).

Conclusions:

Optometric practitioners routinely apply clinical judgment, modifying subjective refractions to create final prescriptions.
Small adjustments are frequent, while substantial changes are less common.
Relying solely on automated or subjective refraction is not advisable due to the importance of clinical judgment.