Use of an automatic refraction device in a Third World country

The vision welfare services in many Third World countries are compromised by the shortage of trained ophthalmic vision care workers. We investigated the feasibility of fulfilling part of the needs in this area by training local personnel in the use of automatic refraction devices. A nurse from the Vila Base Hospital in Vanuatu was given minimal training in the use of such an instrument (Nikon NR 2000), and given guidelines for the preparation of ophthalmic prescriptions. Sixty-nine subjects in the Village of Mélé in Vanuatu were seen by both the nurse and an optometrist, and the prescriptions issued by both workers were compared. The use of automatic refractors under those conditions holds promise for filling the needs in Third World countries, and suggestions are given for adapting these instruments for the particular conditions encountered during this study.