Online Vision Assesment

[HarryChiling]

<VIDEO REMOVED - TOS>

So I was accepted in the preview of the Opternative Online Vision Assessment and first reaction was it was fun and interesting. I don't know about the validity of the test, I am still waiting on an OMD to look over the results but will post my latest script and the script from Opernative with results and opinions when I receive the results.

I have to say I like the idea, the cost was minimal and the test went through some familiar and unfamiliar methods but I understand the methodology of the testing. I will write up an article when the results and my final opinion is in. For the time being I uploaded a video to check out for those that have been watching this interesting new method for visual assessments.

[Craig]

I signed up and am interested in the future. This is a great tool for opticians to help ensure clients can use the vest rx possible.

[HarryChiling]

Removed Video

[Craig]

Why did you remove video at 4 in the morning?

[HarryChiling]

Why did you remove video at 4 in the morning?

TOS = Terms of Service, they don't allow you to post videos of the process. As for the time, the early bird catches the worms. ; )

[ziggy]

Good morning Harry, when taking the test did you receive your results (rx) immediately? The thought of an online refraction spooks me a bit but I think it could be a game changer. If the results are found to be reliable, I would suspect that there will be a lot of independent Opticians using a service such as this.

[Barry Santini]

Why does an online refraction spook you?

B

[ziggy]

I’m really not sure how to answer you, I think it’s a visceral reaction to something out of the norm. Intellectually I understand that a visual assessment can be ascertained using a computer, we have been using auto-refractors for years. Maybe I’m just getting old.

[optical24/7]

The art of refractive prescribing is not simply reading the numbers ANY machine/device spits out.

[drk]

Thank you. I feel completed.

[drk]

Seriously, if you think an autorefractor can provide the optometry end of vision care, then you probably think a machine can provide the opticianry end of vision care, and a 3D printer provides the manufacturing.






We can't be against technology, but we have to use some freaking common sense and tread carefully.

[optimensch]

For now any online assessment would be at best good for a screening, and if it encourages people to go get a real eye exam, (refraction and ocular health), then I think it can be a useful tool. In terms of using it to avoid a proper eye exam, it is a ridiculous idea.
Even with a fully equipped exam room, with refractors, OCTs, perimeters, Visioffices and the latest of every bit of technology - a good exam and good results from glasses/contacts still requires professional skill, time and judgment. Most of the time. Now and then a monkey could prescribe glasses and get it right. Most lay people actually GET this, and would NOT opt for some sort of franken-chip silicon valley virtual crap simulated exam.

[Chris Ryser]

We can't be against technology, but we have to use some freaking common sense and tread carefully.

That is exactly what my father said when the "Radar" was invented and pilots could see miles ahead of them............and even at night, something that was impossible to intelligent minds at the time.

[ziggy]

I didn’t me to imply that an auto refractor can take the place of an OD’s exam, but there are auto refractors out there that are very accurate, good enough to make glasses from.

[drk]

[drk]

That is exactly what my father said when the "Radar" was invented and pilots could see miles ahead of them............and even at night, something that was impossible to intelligent minds at the time.

Yeah, because it's always a bad idea to use common sense and to tread carefully.

Look what happened to him:

[Barry Santini]

What exactly are the metrics defining what makes an "accurate" RX?

B

[optical24/7]

What exactly are the metrics defining what makes an "accurate" RX?

B

Objective AND subjective with much emphasis on the subjective end. Even if you have an auto or cyclo refraction stating/concluding a given Rx, it many times is *tweeked* with subjective experience. As example, you may refract a patient with a 2D bump from their habitual. This much change is many times not acceptable, given all at once to the pt as their final. Until auto-refractors become smart enough to include a reasonable subjective element to the exam they can not be considered *accurate*.

[Uilleann]

As with any thought experiment like this, there will always be stories of success and of failure. My impression is that the rift between the good experiences and the bad will likely widen as compared against a properly equipped doctor's lane (meaning one with a properly equipped and trained doctor in). Those with minor refractive errors, young flexible crystalline lenses, good contrast sensitivity, no alignment/muscular issues or accommodative spasms, may do well with this system. Then there's the other set of folks, likely to have issues, the engineers, those with pathology, any form of alignment issues, amblyopia etc, chronic ocular hypochondriacs (yeah, we all know them), hyperopes, presbyopes, anisometropes, and so on that are likely to end up in an optical dumpster fire.

Removing the ECP from the equation seems likely to only increase the focusing of these two types of likely patients. Ironically, itsn't it strange that no one is pushing for removing the true middle-men that have driven up costs across the industry for decades now, laughing all the way to the bank - the vision "insurance" companies?!

[Craig]

I didn’t me to imply that an auto refractor can take the place of an OD’s exam, but there are auto refractors out there that are very accurate, good enough to make glasses from.

I have tried numerous and they never get me a wearable RX; they are close but the rx is not comfortable. I tried at last VEW on 3 of the latest machines to no avail.

[HarryChiling]

Good morning Harry, when taking the test did you receive your results (rx) immediately? The thought of an online refraction spooks me a bit but I think it could be a game changer. If the results are found to be reliable, I would suspect that there will be a lot of independent Opticians using a service such as this.

No, the Rx doesn't come until after I send in my current Rx. My thought on this are that the testing is checking for VA and any rough axis rotation. From the visual acuity at small changes a defocus error can be computed with a fair degree of accuracy and consistency, the axis tests could determine a rough change in axis from current script to new script which could be then converted into a ratio or weighing factor for the defocus to further break that down into it's higher order components spherical error and cylindrical error. This gives a recipe (Rx) for a new pair of glasses which I would hypothesis could e fairly accurate for a certain range of Rx's and VA changes. A while ago I wrote a python script and posted to this board outlining how to compute a close Rx for mission work, a simple rework of those formulas wound simulate this systems logic.

[HarryChiling]

The art of refractive prescribing is not simply reading the numbers ANY machine/device spits out.

The best way to sum up this exercise is to acknowledge they are targeting the low hanging fruit. I have a fair degree of confidence that the script will be accurate enough, but I also know I am a prime candidate for this type of service and more than likely answered the questions better than most with little anxiety in the process, that means my opinion is definitely biased towards success.

[drk]

No, the Rx doesn't come until after I send in my current Rx. My thought on this are that the testing is checking for VA and any rough axis rotation. From the visual acuity at small changes a defocus error can be computed with a fair degree of accuracy and consistency, the axis tests could determine a rough change in axis from current script to new script which could be then converted into a ratio or weighing factor for the defocus to further break that down into it's higher order components spherical error and cylindrical error. This gives a recipe (Rx) for a new pair of glasses which I would hypothesis could e fairly accurate for a certain range of Rx's and VA changes. A while ago I wrote a python script and posted to this board outlining how to compute a close Rx for mission work, a simple rework of those formulas wound simulate this systems logic.

Wouldn't it be more likely that they send this to some "remote OD" who takes a flying guess?

[Tigerclaw]

Wouldn't it be more likely that they send this to some "remote OD" who takes a flying guess?

Brad Scott, OD? lol

[Sophierhodes]

Yes that you may try also. Optician Software is best for eye test