Hand-Held Nidek versus Table-Mounted Huvitz Autorefractors and Their Agreement with Subjective Refraction in Adults

To compare the agreement between commercially available table mounted and a hand-held autorefractors and their agreement with subjective refraction. The effect of different body position with the handheld autorefractometer was also evaluated.

A prospective study was performed on 253 healthy eyes. Refraction was acquired by a table-mounted Huvitz and hand-held Nidek autorefractometer, subjective refraction was acquired. Refractive errors were compared in terms of spherical equivalent (SE), cylinder power, and the J0 and J45. The level of agreement was evaluated by Bland-Altman plots.

There was a significant difference in SE measurements between both devices and between them and subjective refraction (P=0.00). The Huvitz SE readings tended to be less myopic. However, limits of agreement (LOA) for SE were narrowest for Nidek sitting vs supine followed by Huvitz vs subjective SE refraction. The LOA for SE for Nidek sitting vs subjective SE were of wider range. For cylinder values, LOA were similar for all devices and positions and between them and subjective cylinder refraction.

Table mounted Huvitz and Nidek portable autorefractor cannot be used interchangeably in clinical practice except for estimation of the cylinder power. No difference in refraction between sitting and supine positions for portable Nidek autorefractor but with caution in cylinder axis. High agreement was achieved between subjective refraction and Huvitz readings but not with Nidek hand-held autorefractor. A highly reliable spectacle prescription could be done based on Huvitz readings. Both devices and positions could be used interchangeably in estimation of K-readings.