Results 1 to 25 of 25

Thread: Auto refraction acuity

  1. #1
    Master OptiBoarder tx11's Avatar
    Join Date
    Apr 2012
    Location
    Texas
    Occupation
    Dispensing Optician
    Posts
    822

    Wave Auto refraction acuity

    Have you ever made a pair of glasses solely from an AUTOREFRACTION? How was Pts acuity?

  2. #2
    OptiBoard Professional OptiBoard Bronze Supporter
    Join Date
    Apr 2014
    Location
    wisconsin
    Occupation
    Optometrist
    Posts
    162
    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.

  3. #3
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    You can't be serious.

  4. #4
    Master OptiBoarder
    Join Date
    Jun 2012
    Location
    Mitten State
    Occupation
    Ophthalmic Technician
    Posts
    572
    fjpod, its an interesting theoretical to discuss.

  5. #5
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    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?

  6. #6
    OptiBoard Professional OptiBoard Bronze Supporter
    Join Date
    Apr 2014
    Location
    wisconsin
    Occupation
    Optometrist
    Posts
    162
    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?

  7. #7
    Master OptiBoarder
    Join Date
    Jun 2012
    Location
    Mitten State
    Occupation
    Ophthalmic Technician
    Posts
    572
    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.

  8. #8
    Master OptiBoarder rbaker's Avatar
    Join Date
    May 2000
    Location
    Gold Hill, OR
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    4,357
    Quote Originally Posted by Lelarep View Post
    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.

    He taught and preached retinoscopy to most of the old timers in the business.

  9. #9
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    Quote Originally Posted by Lelarep View Post
    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.
    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.

  10. #10
    Master OptiBoarder RIMLESS's Avatar
    Join Date
    Jul 2004
    Location
    Florida
    Occupation
    Optometrist
    Posts
    423
    Quote Originally Posted by fjpod View Post
    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.
    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 #4
    90% of everything is crap...except for crap, because crap is 100% crap

  11. #11
    Master OptiBoarder tx11's Avatar
    Join Date
    Apr 2012
    Location
    Texas
    Occupation
    Dispensing Optician
    Posts
    822
    so .... ARs cannot produce readings that if placed in a pair of glasses would deliver 20/20 or even 20/20- ?

  12. #12
    Master OptiBoarder RIMLESS's Avatar
    Join Date
    Jul 2004
    Location
    Florida
    Occupation
    Optometrist
    Posts
    423
    Quote Originally Posted by tx11 View Post
    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.

    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.
    90% of everything is crap...except for crap, because crap is 100% crap

  13. #13
    Master OptiBoarder RIMLESS's Avatar
    Join Date
    Jul 2004
    Location
    Florida
    Occupation
    Optometrist
    Posts
    423
    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
    Last edited by RIMLESS; 08-29-2016 at 09:18 AM.
    90% of everything is crap...except for crap, because crap is 100% crap

  14. #14
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    Quote Originally Posted by RIMLESS View Post
    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 #4
    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.

  15. #15
    Master OptiBoarder tx11's Avatar
    Join Date
    Apr 2012
    Location
    Texas
    Occupation
    Dispensing Optician
    Posts
    822
    so.. Definitively... 20/20 or 20/20- not at all possible using ONLY AR.... CORRECT?

  16. #16
    Master OptiBoarder OptiBoard Gold Supporter
    OptiBoard Silver Supporter

    Join Date
    Mar 2012
    Location
    Maryland
    Occupation
    Dispensing Optician
    Posts
    2,088
    Not if I have to cover the cost of the remakes!!!

  17. #17
    Master OptiBoarder RIMLESS's Avatar
    Join Date
    Jul 2004
    Location
    Florida
    Occupation
    Optometrist
    Posts
    423
    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.
    90% of everything is crap...except for crap, because crap is 100% crap

  18. #18
    OptiBoard Apprentice
    Join Date
    Jun 2011
    Location
    Florida
    Occupation
    Optical Retail
    Posts
    47
    I'd be happy to assist in the research...if you take care of the funding, lol!

  19. #19
    Master OptiBoarder RIMLESS's Avatar
    Join Date
    Jul 2004
    Location
    Florida
    Occupation
    Optometrist
    Posts
    423
    Quote Originally Posted by cturtle77 View Post
    I'd be happy to assist in the research...if you take care of the funding, lol!
    Hell, I can't afford you
    90% of everything is crap...except for crap, because crap is 100% crap

  20. #20
    OptiBoard Apprentice
    Join Date
    Oct 2008
    Location
    Ohio
    Occupation
    Dispensing Optician
    Posts
    11
    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.

  21. #21
    OptiBoard Novice
    Join Date
    Aug 2020
    Location
    Sweden
    Occupation
    Optical Retail
    Posts
    2
    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.

  22. #22
    OptiBoardaholic
    Join Date
    Mar 2007
    Location
    Connecticut
    Occupation
    Dispensing Optician
    Posts
    218
    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) before he wised up.

  23. #23
    OptiBoard Novice
    Join Date
    May 2020
    Location
    Canada
    Occupation
    Optical Retail
    Posts
    6
    Quote Originally Posted by Allialli99 View Post
    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.
    I agree with this.

  24. #24
    OptiBoard Novice
    Join Date
    Aug 2020
    Location
    Sweden
    Occupation
    Optical Retail
    Posts
    2
    Quote Originally Posted by Davies View Post
    I agree with this.
    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?

  25. #25
    OptiBoard Apprentice
    Join Date
    Aug 2018
    Location
    Cambridge (UK)
    Occupation
    Optical Laboratory Technician
    Posts
    15
    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.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Open Acuity - Visual Acuity Chart
    By HarryChiling in forum OptiBoard File Directory
    Replies: 3
    Last Post: 11-17-2014, 03:06 PM
  2. Open Acuity - Visual Acuity Chart
    By HarryChiling in forum Ophthalmic Optics
    Replies: 1
    Last Post: 09-28-2014, 02:54 PM
  3. Auto Refraction
    By jhogan in forum General Optics and Eyecare Discussion Forum
    Replies: 15
    Last Post: 03-19-2010, 06:21 AM
  4. Auto Blocker (with built in auto lensometer) and Freeform lenses.
    By sr20bet in forum General Optics and Eyecare Discussion Forum
    Replies: 4
    Last Post: 09-30-2009, 03:46 PM
  5. Looking for an Acuity
    By EdSheridan in forum Optical Marketplace
    Replies: 0
    Last Post: 08-21-2009, 11:28 AM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
OptiBoard is proudly sponsored by:
Younger Optics and Vision Equipment