Department of Biophysics, Physiology and Pathophysiology, Medical University of Warsaw, Warsaw, Poland.
Faculty of Physics, University of Warsaw, Warsaw, Poland.
Optom Vis Sci. 2022 Dec 1;99(12):844-852. doi: 10.1097/OPX.0000000000001962. Epub 2022 Nov 26.
This study was conducted to analyze the influence of binocular vision and accommodation anomalies on refraction dynamics. Our results may help to design more accurate autorefractors and to better understand the difficulties in prescribing an optical correction or adaptation to a correction.
This study aimed to verify whether viewing conditions (open- or closed-field) or vision anomalies, such as ocular surface diseases, accommodative dysfunctions, and binocular vision anomalies, influence (1) the differences between subjective refraction and autorefraction and (2) the characteristics of the short-term refractive state variation.
The subjective refraction of 64 subjects aged 23 to 60 years was measured during a comprehensive optometric examination, and the Ocular Surface Disease Index questionnaire was collected. Twenty successive measurements of automated refraction of each eye were obtained using a conventional autorefractor Nidek ARK-510A and an open-field autorefractor Shin-Nippon NVision-K 5001. Conventional notation of refractive error (sphere, cylinder, axis) was transformed to h-vectors, presented in scatterplots, and analyzed statistically.
The three-way analysis of variance tests showed that there is no influence of accommodation dysfunctions (P = .22 for ARK-510A), binocular vision anomalies (P = .97 for ARK-510A), and ocular surface diseases (P = .20 for ARK-510A) on differences between autorefraction and subjective refraction. The binocular vision anomalies affected the results from open-field autorefractor, whereas the accommodation impacted closed-field refraction measurements. Changes in short-term refractive state variation occurred in sphere power, indicating accommodative state changes; however, 30 subjects demonstrated at least one outlier and/or polymodality of refractive state distributions.
The study showed that the presence of accommodative dysfunctions or binocular vision anomalies might increase the range of short-term refractive state variation. The impact of vision anomalies differs between viewing conditions. The polymodal distribution of refractive state variation and the presence of outliers imply that automatic modes used typically in autorefractors with three to five readings may not accurately represent the refractive state of the eye.
本研究旨在分析双眼视觉和调节异常对屈光动态的影响。我们的研究结果可能有助于设计更准确的自动折射仪，并更好地理解在处方光学矫正或适应矫正方面的困难。
本研究旨在验证视场条件（开或闭）或视觉异常（如眼表疾病、调节功能障碍和双眼视觉异常）是否会影响（1）主观折射和自动折射之间的差异，以及（2）短期屈光状态变化的特征。
在全面的眼科检查中测量了 64 名年龄在 23 至 60 岁的受试者的主观折射，并收集了眼表疾病指数问卷。使用常规自动折射仪 Nidek ARK-510A 和开场自动折射仪 Shin-Nippon NVision-K 5001 对每只眼睛进行了 20 次连续自动折射测量。将常规屈光误差表示（球镜、柱镜、轴位）转换为 h-向量，以散点图形式呈现，并进行统计分析。
三因素方差分析检验表明，调节功能障碍（ARK-510A 时 P =.22）、双眼视觉异常（ARK-510A 时 P =.97）和眼表疾病（ARK-510A 时 P =.20）对自动折射和主观折射之间的差异没有影响。双眼视觉异常影响了开场自动折射仪的结果，而调节则影响了闭场折射测量。短期屈光状态变化的变化发生在球镜力上，表明调节状态的变化；然而，30 名受试者至少有一个离群值和/或屈光状态分布的多模态。
本研究表明，调节功能障碍或双眼视觉异常的存在可能会增加短期屈光状态变化的范围。视觉异常的影响在视场条件之间有所不同。屈光状态变化的多模态分布和离群值的存在意味着通常在具有三到五次读数的自动折射仪中使用的自动模式可能无法准确代表眼睛的屈光状态。
