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Optometrist-guided versus self-driven subjective refraction using tunable optics: quantifying the professional's

Raquel Salvador-Roger1, Abinaya Priya Venkataraman2, Vicente Micó1

  • 1Department of Optics and Optometry and Vision Sciences. University of Valencia. 46100 Burjassot, Spain.

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|March 2, 2026
PubMed
Summary

The do-it-yourself (DIY) subjective refraction method using a tunable liquid lens (TLL) shows comparable accuracy and visual outcomes to professional guidance. This DIY approach offers a feasible, accessible option for remote or hybrid eye exams.

Keywords:
Refractive errorSelf-refractionSubjective refractionTunable lens

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Area of Science:

  • Ophthalmology and Optometry
  • Optical Engineering
  • Human Factors Engineering

Background:

  • Subjective refraction is crucial for determining refractive error.
  • Novel optical systems, like tunable liquid lenses (TLL), offer potential for advanced refraction methods.
  • Evaluating participant-driven approaches is key to expanding access to eye care.

Purpose of the Study:

  • To assess the impact of professional guidance on a new subjective refraction technique using a TLL and Stokes lens.
  • To compare clinician-guided versus participant-driven refraction for accuracy, visual outcomes, and time.

Main Methods:

  • Sixty-six participants (18-44 years) underwent monocular subjective refraction using the same optical system.
  • Two conditions were tested: professional-guided (ORx) and do-it-yourself (DIY) by the participant.
  • Refractive components, visual acuity, and time were analyzed using statistical methods.

Main Results:

  • Both methods demonstrated strong agreement in refractive measurements.
  • A small systematic bias was noted, with slightly more positive spherical equivalents and longer times in the professional-guided group.
  • No statistically significant differences in accuracy or visual outcomes were found between the ORx and DIY methods.

Conclusions:

  • Participant-driven subjective refraction with TLL technology is comparable to professional guidance.
  • The DIY method is a viable, accessible option for hybrid or remote refraction services.
  • Clinician supervision enhanced consistency, but the DIY approach proved feasible and effective.