Evaluation and evolution of an algorithm‐based subjective refraction in children

Aims/Purpose: Assessing a method for refracting children using the Vision‐R™ 800, evaluating usability, followed by examining consistency and clinical relevance of an improved refraction protocol, time savings and children's experience. Methods: Two studies involved Chinese children aged 6 to 13. Study 1 (N = 159) assessed subjective refraction using Vision‐R™ 800 algorithm‐based software (SR1), followed by manual subjective refraction (SSR) and a second algorithm‐based refraction post‐cycloplegia (SR2). Study 2 (N = 66) evaluated SR1 using a modified algorithm and a manual subjective refraction (SSR2) following standard practice post‐cycloplegia. The primary outcomes were the differences and 95% Limits of Agreement (LoA) between the refraction methods, being secondary outcomes method‐duration and children's feedback. Results of right eyes are presented. Results: Study 1 average spherical equivalent (M) of ‐1.50 ± 1.50 D for SR1, ‐1.33 ± 1.57 D for SSR, and ‐1.35 ± 1.58 D for SR2. SR1 was ‐0.17 D more negative than SSR, and LoA was ± 0.75 D (p