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 1...
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| Veröffentlicht in: | Acta ophthalmologica (Oxford, England) England), 2025-01, Vol.103 (S284), p.n/a |
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| creator | Francois, Daniel Ong, Wee Sing Lam, Andrew Kwok‐cheung Liu, Kenneth Ka‐king Longo, Adele |
| description | 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 |
| doi_str_mv | 10.1111/aos.17285 |
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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 < 0.01) with no significant differences between SSR and SR2. Astigmatism differences were clinically insignificant. Timewise, SR1 took 7.64 ± 2.41 mins, SSR 4.94 ± 1.36 mins, and SR2 6.92 ± 2.51 mins. Ratings: SR1: “Okay” 60.4%, “Really Good” 32.1%, “Fantastic” 6.3%.
The initial algorithm protocol was usable and well‐received, with 95% of children completing the examination.
Study 2 found M values of ‐1.14 ± 1.49 D for SR1 and ‐0.93 ± 1.52 D for SSR2, with SR1 being ‐0.22 D more negative than SSR2 (p < 0.01). The LoA were ± 0.50 D for sphere, ± 0.35 D for J0, and ± 0.30 D for J45. These values showed greater consistency and smaller standard deviations in M (0.26D vs.0.38D) compared to Study 1. The modified algorithm reduced refraction time to 5.70 mins for SR1 vs. 4.77 mins for SSR2 (p < 0.05), with SR1 ratings: “Okay” 17%, “Really good” 44.7%, “fantastic” 38.3%, outperforming the earlier program.
Conclusions: While cycloplegic subjective refraction remains the standard for children, the proposed algorithm‐based, non‐cycloplegic refraction with the Vision‐R™ 800 showed reasonable agreement with the cycloplegic standard. This advancement is crucial for exploring alternatives to cycloplegic refraction in future pediatric clinical practices.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.17285</identifier><language>eng</language><publisher>Malden: Wiley Subscription Services, Inc</publisher><subject>Algorithms ; Children ; Children & youth ; Pediatrics ; Refraction ; Vision</subject><ispartof>Acta ophthalmologica (Oxford, England), 2025-01, Vol.103 (S284), p.n/a</ispartof><rights>2025 The Authors Acta Ophthalmologica © 2025 Acta Ophthalmologica Scandinavica Foundation</rights><rights>Copyright © 2025 Acta Ophthalmologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faos.17285$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45551</link.rule.ids></links><search><creatorcontrib>Francois, Daniel</creatorcontrib><creatorcontrib>Ong, Wee Sing</creatorcontrib><creatorcontrib>Lam, Andrew Kwok‐cheung</creatorcontrib><creatorcontrib>Liu, Kenneth Ka‐king</creatorcontrib><creatorcontrib>Longo, Adele</creatorcontrib><title>Evaluation and evolution of an algorithm‐based subjective refraction in children</title><title>Acta ophthalmologica (Oxford, England)</title><description>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 < 0.01) with no significant differences between SSR and SR2. Astigmatism differences were clinically insignificant. Timewise, SR1 took 7.64 ± 2.41 mins, SSR 4.94 ± 1.36 mins, and SR2 6.92 ± 2.51 mins. Ratings: SR1: “Okay” 60.4%, “Really Good” 32.1%, “Fantastic” 6.3%.
The initial algorithm protocol was usable and well‐received, with 95% of children completing the examination.
Study 2 found M values of ‐1.14 ± 1.49 D for SR1 and ‐0.93 ± 1.52 D for SSR2, with SR1 being ‐0.22 D more negative than SSR2 (p < 0.01). The LoA were ± 0.50 D for sphere, ± 0.35 D for J0, and ± 0.30 D for J45. These values showed greater consistency and smaller standard deviations in M (0.26D vs.0.38D) compared to Study 1. The modified algorithm reduced refraction time to 5.70 mins for SR1 vs. 4.77 mins for SSR2 (p < 0.05), with SR1 ratings: “Okay” 17%, “Really good” 44.7%, “fantastic” 38.3%, outperforming the earlier program.
Conclusions: While cycloplegic subjective refraction remains the standard for children, the proposed algorithm‐based, non‐cycloplegic refraction with the Vision‐R™ 800 showed reasonable agreement with the cycloplegic standard. This advancement is crucial for exploring alternatives to cycloplegic refraction in future pediatric clinical practices.</description><subject>Algorithms</subject><subject>Children</subject><subject>Children & youth</subject><subject>Pediatrics</subject><subject>Refraction</subject><subject>Vision</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp1kEtOwzAQhi0EEqWw4AaRWLFIayexnSyrqjykSpV4SOysseNQV2lc7KSoO47AGTkJJkHsmM089M0_ox-hS4InJMQUrJ8QnuT0CI0IpzROOcuP_2r6corOvN9gzAhj2Qg9LPZQd9Aa20TQlJHe27rrO1uFQQT1q3WmXW-_Pj4leF1GvpMbrVqz15HTlQPV06aJ1NrUpdPNOTqpoPb64jeP0fPN4ml-Fy9Xt_fz2TJWBCc0ViXLSaVVVkDJGcdJkkpMSJGXoCUtCoJlhjHPtMwxgARW6QJLShNIZYWzIh2jq0F35-xbp30rNrZzTTgpUkI5TkmSsEBdD5Ry1vvwsdg5swV3EASLH8tEsEz0lgV2OrDvptaH_0ExWz0OG980gm7i</recordid><startdate>202501</startdate><enddate>202501</enddate><creator>Francois, Daniel</creator><creator>Ong, Wee Sing</creator><creator>Lam, Andrew Kwok‐cheung</creator><creator>Liu, Kenneth Ka‐king</creator><creator>Longo, Adele</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope></search><sort><creationdate>202501</creationdate><title>Evaluation and evolution of an algorithm‐based subjective refraction in children</title><author>Francois, Daniel ; Ong, Wee Sing ; Lam, Andrew Kwok‐cheung ; Liu, Kenneth Ka‐king ; Longo, Adele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1025-cd681fec49ad7670223b01198daeb59910b40074eb80aaba6fe90b552a3bf0493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Algorithms</topic><topic>Children</topic><topic>Children & youth</topic><topic>Pediatrics</topic><topic>Refraction</topic><topic>Vision</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Francois, Daniel</creatorcontrib><creatorcontrib>Ong, Wee Sing</creatorcontrib><creatorcontrib>Lam, Andrew Kwok‐cheung</creatorcontrib><creatorcontrib>Liu, Kenneth Ka‐king</creatorcontrib><creatorcontrib>Longo, Adele</creatorcontrib><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Francois, Daniel</au><au>Ong, Wee Sing</au><au>Lam, Andrew Kwok‐cheung</au><au>Liu, Kenneth Ka‐king</au><au>Longo, Adele</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation and evolution of an algorithm‐based subjective refraction in children</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><date>2025-01</date><risdate>2025</risdate><volume>103</volume><issue>S284</issue><epage>n/a</epage><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>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 < 0.01) with no significant differences between SSR and SR2. Astigmatism differences were clinically insignificant. Timewise, SR1 took 7.64 ± 2.41 mins, SSR 4.94 ± 1.36 mins, and SR2 6.92 ± 2.51 mins. Ratings: SR1: “Okay” 60.4%, “Really Good” 32.1%, “Fantastic” 6.3%.
The initial algorithm protocol was usable and well‐received, with 95% of children completing the examination.
Study 2 found M values of ‐1.14 ± 1.49 D for SR1 and ‐0.93 ± 1.52 D for SSR2, with SR1 being ‐0.22 D more negative than SSR2 (p < 0.01). The LoA were ± 0.50 D for sphere, ± 0.35 D for J0, and ± 0.30 D for J45. These values showed greater consistency and smaller standard deviations in M (0.26D vs.0.38D) compared to Study 1. The modified algorithm reduced refraction time to 5.70 mins for SR1 vs. 4.77 mins for SSR2 (p < 0.05), with SR1 ratings: “Okay” 17%, “Really good” 44.7%, “fantastic” 38.3%, outperforming the earlier program.
Conclusions: While cycloplegic subjective refraction remains the standard for children, the proposed algorithm‐based, non‐cycloplegic refraction with the Vision‐R™ 800 showed reasonable agreement with the cycloplegic standard. This advancement is crucial for exploring alternatives to cycloplegic refraction in future pediatric clinical practices.</abstract><cop>Malden</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/aos.17285</doi><tpages>1</tpages></addata></record> |
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| subjects | Algorithms Children Children & youth Pediatrics Refraction Vision |
| title | Evaluation and evolution of an algorithm‐based subjective refraction in children |
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