Have you ever made a pair of glasses solely from an AUTOREFRACTION? How was Pts acuity?
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Have you ever made a pair of glasses solely from an AUTOREFRACTION? How was Pts acuity?
So many ifs... But if I had to, I'd do it dilated to negate accommodation that sometimes gives funny readings on kids/teens. Depending on the instrument, I imagine 20/20 would be a fairly common occurrence. The quality of that 20/20 might not be the greatest but your probably in the ballpark.
You can't be serious.
fjpod, its an interesting theoretical to discuss.
Would you measure a PD with a yardstick? Were you trained to believe that an objective autorefraction is the equivalent of subjective refinement and Rx?
Maybe I was wrong to assume the OP was implying there was no means of getting a reliable subjective on the patient?? Sometimes retinoscopy is difficult as well if the patient doesn't cooperate. I think auto is a great tool, but not one to Rx exclusively from, like other posters seem to think the op is saying.
I guess I should ask the OP: is the Rx just a string of numbers to you or do they have meaning?
I do know a guy who does autorefraction on medical missions to impoverished areas of the world. He used an autorefractor with dilation. It just isn't possible to manually refract every person they meet that needs glasses. I mean, they have lines that people wait in for days. This is one of those situations where "close enough" is way better than "nothing", especially when operating under way less than optimal conditions.
As I recall, Jack Copeland used to scope hundreds of our grandparents a day at Ellis Island. Didn't write any Rx's, merely screened the great hordes of unwashed immigrants for gross refractive errors, but he became so proficient that he later was able to determine refractive error with great accuracy. His streak retinoscope is now found in nearly every exam room although seldom used today.Quote:
Originally Posted by Lelarep
He taught and preached retinoscopy to most of the old timers in the business.
A good clinician can do a static retinoscopy, without dilation, on a patient quicker, and more accurately than using an auto-refractor. Patients that cannot be done with retinoscopy, (due to small pupils, or media opacities) can not be done with an auto-refractor either. Dilation simply increases time in both cases.Quote:
Originally Posted by Lelarep
Somewhat true. And a skilled carpenter can frame a house with a handsaw but never would. The reality is today's A/R are very accurate and allow a good starting point even if you want to follow up with #4Quote:
Originally Posted by fjpod
so .... ARs cannot produce readings that if placed in a pair of glasses would deliver 20/20 or even 20/20- ?
That's a tricky one to answer. And every OD would chime in with a different response for sure. To say that an A/R refraction would not deliver 20/20 is the same as saying Retinoscopy would not deliver 20/20.Quote:
Originally Posted by tx11
Here's what I would say and I think that this is what you are curious about...if you RX'd off of an A/R without a subjective you would probably bat about 500-600.
The only time I would strictly Rx off of Retinoscopy alone is when the patients responses were deemed unreliable.
Retinscopy gives the clinician a better feel for what's going on. You get to judge a reflex and any opacity in the optical system of the eye at the same time as you gauge the refraction. A/R most gives you just the refractive data
A good and smart carpenter would never build an entire house with a hand saw because it would take a lot longer to build the house.Quote:
Originally Posted by RIMLESS
so.. Definitively... 20/20 or 20/20- not at all possible using ONLY AR.... CORRECT?
Not if I have to cover the cost of the remakes!!!
That would be an interesting study. Perhaps take a 100 single vision RX's and fill them from an auto refractor and see how many bounce.
I'd be happy to assist in the research...if you take care of the funding, lol!
Hell, I can't afford you:bounce:Quote:
Originally Posted by cturtle77
I think I have filled several of these from local Ophthalmology practices who simply finalize the AutoRefraction the tech submitted to the Dr.
I think mathematically they are probably not that far off. I think in terms of 'the art of dispensing', as in consideration of last rx/adaptation/lifestyle and use they can be a world away from where they need to be.
Everyone should be open-minded to new tech coming with binocular auto-refractions or abberometers combined with subjective refractions in one single module. Many hyperopics with available accomodation and -0.50 to -1.0 myopics will be prescribed solely on the auto-refraction.
When they were fairly new, we had an MD in the area that though his autorefractor was the "hand of God" coming down, tapping the pt. on the head and handing them an Rx. "But that's what the autorefractor determined." It took several years. Countless return visits and many remakes (at my expense of course:stomp:) before he wised up.
I agree with this.Quote:
Originally Posted by Allialli99
Is it possible to prescribe myopes -0.50 to -1.00 with no astigmatism and mild hyperopes 0.50 to 2.0 direct from auto-refraction assuming px does not have current glasses? Any comments?Quote:
Originally Posted by Davies
Because of a lack of regulation, there is actually a company in my current country of employment that does fill RX's solely based on what the autorefractor spits out.
Not a single opticien or other knowledgeable optical staff is involved in the making of these glasses, even if they persist in saying the process is overseen by aforementioned persons.
Seeing as I'm not as experienced as some of the members here, I can't say whether wearing a set of glasses that is definitely not up to standard can cause unwanted effects.
But IMHO it should definitely be either regulated or just outright prohibited. This opinion was created over the last few years having companies like Charlie Temple and EyeLove (both of which sell either glasses online or with just autorefraction) producing the most horrendous jobs I have seen in my short career.
Consequently people come to our store asking if we can fix them?
We can if it's not prescription related.
But we can't fix the attitude. Wanting the best for the least amount of money is a recipe for disaster.