Visual acuity measured with a 3 mm pupil and Maxwellian view for subjective vs. objective focus in patients with...

We demonstrate a potential vision tester (PVT), designed to improve the accuracy of visual acuity (VA) measurements in older eyes with exudative retinal disease quantified by optical coherence tomography (OCT). Key features include a high-resolution visual display presented in Maxwellian view, a 3 mm pupil to limit wavefront (WF) aberrations, a selected fixed cylinder lens to correct astigmatism, and a tunable lens to correct sphere. An external Hartmann-Shack-based autorefractor provided objective sphere and cylinder corrections. Subjective values of the sphere were obtained by the patient adjusting the tunable lens. VA was measured using four alternative forced choice for a single black-on-white E stimulus. In patients with exudative retinal disease, VAs did not differ when using the objective vs. subjective sphere values. The significant difference in the myopic direction for two subjective settings (-0.093, -0.28 D) vs. one objective setting (0.0 D) was too small to cause a difference in VA for this patient group, supporting the use of an autorefractor for VA measurements.