The Direct Subjective Refraction: Unsupervised measurements of the subjective refraction using defocus waves

Abstract We present the Direct Subjective Refraction (DSR), a new subjective refraction method, and validate it vs the Traditional Subjective Refraction (TSR) and an unsupervised version of it (UTSR). We project an optotunable lens onto the eye to create Temporal Defocus Waves produces flicker and chromatic distortions, minimum when the mean optical power of the wave matches the spherical equivalent of the eye. 25 subjects performed the DSR visual and UTSR tasks without supervision. DSR is more repeatable than TSR and UTSR (standard deviations ±0.17D, ±0.28, and ±0.47D). The time per repetition of DSR is only 39s (almost 6 min for TSR). Cyclopegia severely affects UTSR, but not DSR, confirming that the DSR task de-activates the accommodative system. DSR is a new method to obtain the spherical equivalent that does not requires supervision and overpasses existing subjective methods in terms of accuracy, precision, and measurement time.