Systematic measurement errors involved in over-refraction using an autorefractor (Grand-Seiko WV-500): is measurement of accommodative lag through spectacle lenses valid?
OBJECTIVE
Lags of accommodation in ametropic children are often evaluated through spectacle lenses (over-refraction). This study investigated the validity of over-refraction when using an autorefractor.


METHODS
Using an autorefractor (Shin-Nippon SRW-500/Grand-Seiko WV-500), refractive readings were obtained in 25 cyclopleged eyes (mean +/- S.D. refraction: -3.44 +/- 3.56 D, range: from -10.56 to +0.25 D) while placing spherical lenses of different power (from -5.00 to +5.00 D) in front of the eye at a vertex distance of 12 mm. Based on the refractive readings with and without the lens, and the lens power, measurement errors were estimated. Similarly, the measurement errors were estimated also in model eyes of -10.00, -4.75, 0.00 and +10.00 D. The results were compared with ray-tracing simulations based on the internal specifications of the autorefractor.


RESULTS
Measurement errors were found unless the power of the spectacle lens was equal to the refractive error of the eye. When the spectacle lens power was greater (less myopic or more hyperopic) than the refraction of the eye, the measurement error was negative in sign and greater than -0.3 D. It follows that, when an accommodative response is measured in myopic subjects, the refractive reading usually becomes more myopic than the refraction of the eye including the accommodative response; hence, the accommodative response is overestimated, and the lag of accommodation is underestimated.


CONCLUSIONS
The autorefraction through spectacle lenses involved systematic measurement errors. The extent of the errors is usually small but needs to be taken into account in a comparative study of accommodative responses among different refractive groups.
Kimura
Shuhei
S
Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Hasebe
Satoshi
S
Ohtsuki
Hiroshi
H
D000065:Accommodation, Ocular / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D003941:Diagnostic Techniques, Ophthalmological / Q000592:standards*; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology*; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis*; D014787:Vision Tests / Q000592:standards*; D014792:Visual Acuity