Clinical evaluation of refraction using a handheld wavefront autorefractor in young and adult patients

PURPOSE: To determine the accuracy of measurement by the SureSight autorefractor (software version 2.0) and the influence of accommodation. SETTING: Pediatric Section, Department of Ophthalmology, University of Hamburg, Hamburg, Germany. METHODS: In a series of comparative measurements, autorefractor readings were compared with cycloplegic retinoscopy in 195 eyes of 108 patients (1 to 81 years) measured under cycloplegia. Ninety-six eyes were also measured without cycloplegia. RESULTS: The wavefront autorefractor was able to refract human eyes from a distance of 0.35 m. The accuracy was lower than that with conventional tabletop autorefractors. A difference of less than 0.51 diopter (D) was found in 68% of the spherical equivalents under cycloplegia. Many emmetropic and hyperopic children accommodated during the noncycloplegic measurements and were minus-overcorrected up to -6.13 D. In our group of young patients (2 to 17 years), 47% were minus-overcorrected by more than -2.00 D. CONCLUSIONS: The wavefront autorefractor uses a new method to determine the refractive state of the eye from a distance. It was less accurate than other conventional autorefractors. A benefit is its application in infants and disabled and uncooperative subjects. Cycloplegia is necessary in young hyperopic patients.