title: Evaluation of the measurement of refractive error by the PowerRefractor: a remote, continuous and binocular measurement system of oculomotor function.
abstract: OBJECTIVE
  The technique of photoretinoscopy is unique in being able to measure the dynamics of the oculomotor system (ocular accommodation, vergence, and pupil size) remotely (working distance typically 1 metre) and objectively in both eyes simultaneously. The aim of this study was to evaluate clinically the measurement of refractive error by a recent commercial photoretinoscopic device, the PowerRefractor (PlusOptiX, Germany).
  
  
  METHODS
  The validity and repeatability of the PowerRefractor was compared to: subjective (non-cycloplegic) refraction on 100 adult subjects (mean age 23.8 (SD 5.7) years) and objective autorefraction (Shin-Nippon SRW-5000, Japan) on 150 subjects (20.1 (4.2) years). Repeatability was assessed by examining the differences between autorefractor readings taken from each eye and by re-measuring the objective prescription of 100 eyes at a subsequent session.
  
  
  RESULTS
  On average the PowerRefractor prescription was not significantly different from the subjective refraction, although quite variable (difference +0.05 (0.63) D, p=0.41) and more negative than the SRW-5000 prescription (by -0.20 (0.72) D, p<0.001). There was no significant bias in the accuracy of the instrument with regard to the type or magnitude of refractive error. The PowerRefractor was found to be repeatable over the prescription range of -8.75D to +4.00D (mean spherical equivalent) examined.
  
  
  CONCLUSIONS
  The PowerRefractor is a useful objective screening instrument and because of its remote and rapid measurement of both eyes simultaneously is able to assess the oculomotor response in a variety of unrestricted viewing conditions and patient types.
authors.affiliation: Neurosciences Research Institute, School of Life and Health Sciences, Aston University, Birmingham, UK.
authors.forename: O A
authors.initials: OA
authors.lastname: Hunt
authors.forename: J S
authors.initials: JS
authors.lastname: Wolffsohn
authors.forename: B
authors.initials: B
authors.lastname: Gilmartin
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009907:Optometry / Q000295:instrumentation*; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity