Boston Child Self-Refraction Study

Introduction: Uncorrected refractive error is a major cause of visual impairment in the developing world, where access to refractive care, especially for children, is difficult or impossible. Currently, many efforts are underway to address this deficit. One approach is to use novel self-adjustable eyeglasses called Adspecs, developed by Dr. Josh Silver of Oxford, England. Studies were recently carried out in urban and rural China and in Boston. This paper discusses the results from the Boston Child Self-Refraction Study.

Methods: 292 children 12-15 years of age met the inclusion criteria of ≤ 20/40 unaided VA in both eyes, best corrected cycloplegic VA ≥ 20/30 in both eyes, no ocular pathologies or amblyopia, and ≤ -1.25D astigmatism in either eye. Subjects performed self-refraction on themselves through Adspecs and then had VA measured. The prescription of the Adspecs was measured on a lensometer. Subjects then had a cycloplegic refraction, autorefraction, and ocular health assessment performed, with VA measured through the cycloplegic subjective RX.

Results: Self-refraction resulted in a mean spherical difference of -0.23D compared to cycloplegic subjective refraction. 98.6% of eyes achieved VA ≥ 20/30 and 93.7% VA ≥ 20/25 through their self-refraction.

Discussion: The VA through self-refraction resulted in excellent vision for most subjects, and the accuracy was a mean of less than 0.25D overminused compared to cycloplegic refraction. The combination of excellent vision and accurate spherical refraction derived from self-refraction provide encouragement for further investigation of this technique for myopic children in regions where access to refractive care is limited.