Evaluating Self-Refraction and Ready-Made Spectacles for Treatment of Uncorrected Refractive Error.

Purpose: Uncorrected refractive error is the leading cause of visual impairment worldwide and has significant quality of life and economic implications. Treatment with subjective refraction and custom-made spectacles requires expensive equipment and highly trained personnel. We examine several alternatives.

Methods: Patients were taught to self-refract using two devices: AdSpecs and the I-test Vision Screener. Ready-made spectacles were fit to the self-refraction and visual acuity (VA) was measured. Donated-spectacles were fit to subjective refraction and VA was measured. Self-refraction and donated spectacles spherical equivalent (SE) and VA were compared to subjective refraction SE and VA.

Results: About 57 patients (102 eyes) were enrolled in the study. Patients accurately determined refractive power with self-refraction by both AdSpecs and the I-test (compared to subjective refraction SE, r = 0.97 and r = 0.94, respectively). SE of donated spectacles fit well with self-refraction SE (r = 0.91). There was no significant difference between best-corrected VA by subjective refraction and VA treated by ready-made spectacles fit to self-refraction by either device (analysis of variance (ANOVA), p non-significant). Patients fit with donated spectacles had significantly worse VA than best-corrected VA by subjective refraction (ANOVA, p < 0.01), although 80% improved to >20/40.

Conclusion: Patients accurately self-refract using both devices and ready-made spectacles fit to self-refraction have excellent visual outcomes. Donated spectacles have worse visual outcomes but might be useful in a subset of patients. Ready-made spectacles fit to self-refraction may provide a treatment alternative to uncorrected refractive error.