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Related Experiment Video

Updated: Mar 3, 2026

Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
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Age-Related Clinical Agreement Between Noncycloplegic Autorefraction and Subjective Refraction: A Power-Vector

Ozlem Candan1, Irem Saglam1, Gozde Orman1

  • 1Department of Ophthalmology, Ankara Training and Research Hospital, Turkish Ministry of Health, Ankara, Turkey, saglik.gov.tr.

Journal of Ophthalmology
|March 2, 2026
PubMed
Summary

Noncycloplegic autorefraction shows high agreement with subjective refraction for spherical equivalent (SE) across ages. Astigmatic changes with age were minimal, but subjective refinement is key for precise axis determination.

Keywords:
age-related refraction changesautorefractionpower vector analysisspherical equivalentsubjective refraction

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Accurate refractive error assessment is crucial for visual health.
  • Noncycloplegic autorefraction is a common initial step in eye examinations.
  • Understanding its agreement with subjective refraction across diverse populations is essential for clinical practice.

Purpose of the Study:

  • To evaluate the agreement between noncycloplegic autorefraction and subjective refraction.
  • To analyze agreement across different age groups and refractive error types.
  • To use clinically meaningful thresholds for spherical and astigmatic components.

Main Methods:

  • Retrospective analysis of 827 eyes from patients aged 7-85 years.
  • Objective refraction measured by KR-1 autorefractor, followed by subjective refinement.
  • Fourier vector analysis for spherical equivalent (SE), cylinder power (CP), and power vectors (J0, J45).

Main Results:

  • High agreement for SE (90.8% within ±0.50 D) across all ages.
  • Progressive shift in J0 (astigmatism) with age; J45 remained near zero.
  • Axis deviations >10° occurred in 27.2% of eyes, mainly with low cylinder power, suggesting limited visual impact.

Conclusions:

  • Noncycloplegic autorefraction demonstrates high agreement with subjective refraction for SE in adolescents and adults.
  • Age-related astigmatic shifts are minimal and have limited clinical impact.
  • Subjective refinement is vital for precise axis determination, especially in specific refractive conditions and older adults.