Photorefraction with a catadioptric lens. Improvement on the method of Kaakinen

Kaakinen (1979) presented a method of measuring refractive error and ocular alignment by simultaneous photography of corneal and fundus reflexes. As presented, the technique was unable to detect refractive errors of less than 2-3 diopters (Howland 1980; Kaakinen 1979). We demonstrate that the use of a catadioptric lens and a long working distance can improve sensitivity to less than 1.0 D. Refractions of a model eye, an accommodating eye and ametropic eyes indicate that refractive errors greater than 0.75 D are readily detectable. The improvement in sensitivity achieved by the present system is attributable to a reduction of the angle between the flash source and the entrance pupil of the photorefractor.