Camp Andrew S, Shane Thomas S, Kang Julia, Thomas Benjamin, Pole Cameron, Lee Richard K
a Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , Florida , USA.
b Shiley Eye Institue , La Jolla , California , USA.
Ophthalmic Epidemiol. 2018 Oct-Dec;25(5-6):392-398. doi: 10.1080/09286586.2018.1500615. Epub 2018 Aug 17.
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.
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.
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.
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.
未矫正的屈光不正为全球视力损害的主要原因，且对生活质量和经济有着重大影响。主观验光和定制眼镜的治疗需要昂贵的设备和训练有素的人员。我们研究了几种替代方法。
指导患者使用两种设备进行自我验光：AdSpecs和I-test视力筛查仪。根据自我验光结果佩戴现成眼镜，并测量视力（VA）。根据主观验光结果佩戴捐赠眼镜，并测量视力。将自我验光和捐赠眼镜的球镜当量（SE）及视力与主观验光的SE及视力进行比较。
约57例患者（102只眼）纳入研究。患者通过AdSpecs和I-test进行自我验光时能准确测定屈光力（与主观验光SE相比，r分别为0.97和0.94）。捐赠眼镜的SE与自我验光SE拟合良好（r = 0.91）。主观验光的最佳矫正视力与两种设备根据自我验光结果佩戴现成眼镜治疗后的视力之间无显著差异（方差分析（ANOVA），p无显著性）。佩戴捐赠眼镜的患者视力明显低于主观验光的最佳矫正视力（ANOVA，p < 0.01），尽管80%的患者视力提高到>20/40。
患者使用这两种设备都能准确进行自我验光，根据自我验光结果佩戴现成眼镜具有良好的视觉效果。捐赠眼镜的视觉效果较差，但可能对一部分患者有用。根据自我验光结果佩戴现成眼镜可为未矫正的屈光不正提供一种治疗选择。
