Subjective Refraction Test Using a Smartphone for Vision Screening

To improve access to vision care and to enable mass vision screening, a smartphone app has been developed to measure refractive errors. Without needing any external attachment, the app running on a standalone phone can be used by lay personnel to measure subjective refraction. Its validity has been pilot-tested in clinical settings and underserved communities. The app estimates the refractive error by measuring the distances of far points for discerning visual stimuli. Spherical equivalent refraction and astigmatism can be measured using Tumbling E letters and grating patterns, respectively. The purpose of this paper is to describe the measurement protocols for performing subjective refraction using the app. Experimental results with 34 subjects (30 eyes for spherical equivalent and 38 eyes for astigmatism assessment) are presented. Measurement with the app was compared with standard clinical methods. The average absolute error of spherical equivalent refraction was 0.63D, and the average absolute error of astigmatism measurement was 0.28D. In addition, 22 subjects were enrolled to evaluate inter-pupillary distance (IPD) measurement with the app. The average absolute error in IPD measurement with the app was 1.2 mm. The protocol for measuring IPD with the app is also described.