Related Experiment Video
Updated: Mar 30, 2026
Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Design and Clinical Evaluation of a Handheld Wavefront Autorefractor
Nicholas J Durr1, Shivang R Dave, Fuensanta A Vera-Diaz
1*PhD †OD, PhD Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts (NJD, SRD, DL, EL); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland (NJD); New England College of Optometry, Boston, Massachusetts (FAV-D, FT); Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas, Madrid, Spain (CD, SM); and Instituto de Investigaciones Biomédicas "Alberto Sols," UAM/CSIC, Madrid, Spain (EL).
Purpose:
To introduce a novel autorefractor design that is intended to be manufacturable at low cost and evaluate its performance in measuring refractive errors.
Methods:
We developed a handheld, open-view autorefractor (the "QuickSee" [QS]) that uses a simplified approach to wavefront sensing that forgoes moving parts and expensive components. Adult subjects (n = 41) were recruited to undergo noncycloplegic refraction with three methods: (1) a QS prototype, (2) a Grand Seiko WR-5100K (GS) autorefractor, and (3) subjective refraction (SR). Agreements between the QS and GS were evaluated using a Bland-Altman analysis. The accuracy of both autorefractors was evaluated using SR as the clinical gold standard.
Results:
The spherical equivalent powers measured from both autorefractors correlate well with SR, with identical correlation coefficients of r = 0.97. Both autorefractors also agree well with each other, with a spherical equivalent power 95% confidence interval of ±0.84 diopters (D). The difference between the accuracy of each objective device is not statistically significant for any component of the power vector (p = 0.55, 0.41, and 0.18, for M, J0, and J45, respectively). The spherical and cylindrical powers measured by the GS agree within 0.25 D of the SR in 49 and 82% of the eyes, respectively, whereas the spherical and cylindrical powers measured by the QS agree within 0.25 D of the SR in 74 and 87% of the eyes, respectively.
Conclusions:
The prototype autorefractor exhibits equivalent performance to the GS autorefractor in matching power vectors measured by SR.
