Comparing Close-Field and Open-Field Autorefractometry and Subjective Refraction

Background/Objectives: Autorefractometers are valuable tools in clinical practice, but their accuracy is often questioned, especially in the pediatric population. This study aimed to compare refraction data from open-field and close-field autorefractometers and subjective refraction without using cycloplegia. Methods: A total of 50 eyes of 50 participants (19 males and 31 females, 11.8 ± 1.56 years) were evaluated. In a single visit, objective refraction was performed using NVision-K 5001 (open-field) and Visionix VX120 (close-field) autorefractometers, and subjective refraction using the fogging technique. Differences between procedures were assessed for sphere, spherical equivalent, and cylindrical vectors J₀ and J₄₅ using the Friedman test, followed by the post hoc Wilcoxon test as needed. Results: Significant differences were found in the sphere between the three procedures (all p ≤ 0.032). For the spherical equivalent, the Visionix VX120 differed significantly with the other two techniques (both p < 0.001), whereas no significant differences were found between NVision-K 5001 and subjective refraction (p = 0.193). Finally, no significant differences were observed for J₀ and J₄₅ vectors among the procedures (both p ≥ 0.166). Conclusions: There are certain discrepancies between autorefractometers and the subjective assessment of refractive error, most evident in measurements taken with the close-field device, possibly due to greater accommodative stimulation. However, in contexts such as visual screening or as a preliminary guide in the clinic, the values obtained by autorefractometry can provide useful information.