Carlos S. Hernández, Andrea Gil, Ignacio Casares, Jesús Poderoso, Alec Wehse, Shivang R. Dave, Daryl Lim, Manuel Sánchez-Montañés, Eduardo Lage. Prediction of manifest refraction using machine learning ensemble models on wavefront aberrometry data. Journal of Optometry, 2022. ISSN 1888-4296, https://doi.org/10.1016/j.optom.2022.03.001.
Key findings
Machine learning methods are effective for improving precision in predicting patient’s subjective refraction from objective measurements taken with a low-cost portable device.
Agreement with subjective refraction for M, J0, and J45 was considerably improved compared to the baseline results provided by the autorefractor.
The machine learning approach, implementable via software, may potentially improve upon the accuracy of the handheld autorefractor used in the study in a cost-effective manner.
The technology could be applied to other autorefractors to improve access to vision correction by non-technical ECPs in health disparity populations.
Gil, A., Hernández, C.S., Nam, A.S. et al. Predicting subjective refraction with dynamic retinal image quality analysis. Sci Rep 12, 3714 (2022). https://doi.org/10.1038/s41598-022-07786-0
Key findings
Dynamic retinal image analysis using wavefront aberrometry can dramatically improve the accuracy of autorefraction results to predict a vision correction prescription.
Incorporating these advanced algorithms into portable wavefront autorefractors can improve the 0.25D agreement with subjective refraction by 15%.
An autorefractor using dynamic wavefront aberrometry and these analytic techniques can produce more reliable results than the vast majority of autorefractors that rely on static measurements.
Joseph S, Varadaraj V, Dave SR, Lage E, Lim D, Aziz K, Dudgeon S, Ravilla TD, Friedman DS, Investigation of the accuracy of a low-cost, portable, autorefractor to provide well-tolerated eyeglass prescriptions: a randomized crossover trial, Ophthalmology (2021), doi: https:// doi.org/10.1016/j.ophtha.2021.05.030.
Key findings
Prescriptions from QuickSee autorefraction measurements showed strong agreement with prescriptions from subjective refraction.
Eyeglasses prescribed from QuickSee measurements were preferred equally to those prescribed from subjective refraction.
QuickSee can help expand access to eyeglass prescriptions where there is a shortage of professionals and traditional clinical equipment to meet the need.
Gil A, Hernández CS, Pérez-Merino P, Rubio M, Velarde G, Abellanas-Lodares M, et al. (2020) Assesment of the QuickSee wavefront autorefractor for characterizing refractive errors in school-age children. PLoS ONE 15(10): e0240933.
Key findings
The high-level of agreement between QuickSee and subjective refraction, as well as the resulting VA achieved by the patients in both study groups, suggest that the device would serve as a useful autorefraction tool for pediatric populations.
The device’s robust screening metrics, along with its ease of use and handheld form factor, support its use as a pediatric vision screening tool.
Sanil Jospeh, David S Friedman, Thulasiraj Ravilla, Shivang Dave, Eduardo Lage, Varshini Varadaraj, Kanza Aziz; Investigation of the accuracy of a low-cost, portable, auto-refractor to provide well-tolerated eyeglass prescriptions. Invest. Ophthalmol. Vis. Sci. 2020;61(7):528.
Key findings:
Ahhyun Stephanie Nam, Varshini Varadaraj, Alyssa Marie Kretz, Kanza Aziz, Marcos Rubio, Andrea Gil, Daryl Lim, Shivang Dave, David S Friedman, Nicholas J. Durr, Eduardo Lage; Assessment of wavefront measurements from a low-cost, portable, aberrometry-based autorefractor. Invest. Ophthalmol. Vis. Sci. 2020;61(7):531.
Key finding:
Rubio, Marcos, et al. “Validation of an Affordable Handheld Wavefront Autorefractor” Optom. Vis. Sci., vol. 96, no. 10, pp. 726–732, Oct. 2019.
Key findings
Visual acuity resulting from correction based on QuickSee measurements was the same as that achieved by subjective refraction in 87% of the eyes. This improvement in visual acuity is comparable to that reported for clinically established benchtop systems.
Agreement between the three refraction components (M, J0, J45) provided by QuickSee and subjective refraction is within 0.5 D in more than 85 % of the cases.
This research suggests that QuickSee provides measurements that agree more closely with subjective refraction than other handheld autorefractors.
Agarwal A, Bloom DE, deLuise VP, Lubet A, Murali K, Sastry SM (2019) Comparing low-cost handheld autorefractors: A practical approach to measuring refraction in low-resource settings. PLoS ONE 14(10): e0219501.
Key findings
Refractive error can be accurately measured using affordable and handheld devices
Pre-production QuickSee prototype outperformed Retinomax and Netra portable autorefractors
QuickSee was found most accurate compared to subjective refraction, and suitable for epidemiological screening and as a diagnostic tool
Durr NJ, Dave SR, Lim D, et al. Quality of eyeglass prescriptions from a low-cost wavefront autorefractor evaluated in rural India: results of a 708-participant field study. BMJ Open Ophthalmology 2019;4:e000225. doi:10.1136/ bmjophth-2018-000225
Key findings
Eyeglass prescriptions can be accurately measured by a minimally trained technician using a low-cost wavefront autorefractor in rural India.
Data from 708 participants indicate a marginal difference in both prescription preference and resulting visual acuity between eyeglasses derived from subjective refraction versus QuickSee autorefraction (VA from QuickSee was on average only one eye chart letter worse).
Among the 438 participants 40 years old and younger, there was no statistically significant difference in the preferences for eyeglasses derived from subjective refraction versus QuickSee autorefraction.
E. Lage, et al. “Visual acuity evaluation with refractions prescribed by a novel low-cost wavefront aberrometer” Invest. Ophthalmol. Vis. Sci., 2015, vol. 56, p. 3570.
N. J. Durr, et al. From Unseen to Seen: Tackling the Global Burden of Uncorrected Refractive Errors. Annual Review of Biomedical Engineering, Vol. 16:131-153, Jul. 2014
Padhy D, Bharadwaj SR, Nayak S, Rath S, Das T. Does the accuracy and repeatability of refractive error estimates depend on the measurement principle of autorefractors?. Trans Vis Sci Tech. 2021;10(1):2, https://doi.org/10.1167/tvst.10.1.2
Samanta A, Shetty A, Nelson PC. Better one or two? A systematic review of portable automated refractors. Journal of Telemedicine and Telecare. August 2020. doi:10.1177/1357633X20940140
IAPB Eye Health Technology Guide
International Agency for the Prevention of Blindness (IAPB), 2023
The Sustainable Development Goals Report
United Nations, 2020
Eyeglasses for Global Development: Bridging the Visual Divide
Eyelliance Report 2016
Vision 2020: The Right to Sight. Global initiative for the elimination of avoidable blindness, Action plan 2006-2011.
IAPB / Vision 2020 / World Health Organization
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