Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 18;18(3):504-509.
doi: 10.18240/ijo.2025.03.18. eCollection 2025.

Autorefraction versus subjective refraction in high astigmatism

Haleh Kangari  1 , Hassan Hashemi  2 , Saeed Rahmani  1 , Elnaz Ahmadian  3 , Abbasali Yekta  4 , Mehdi Khabazkhoob  5
Affiliations

Autorefraction versus subjective refraction in high astigmatism

Haleh Kangari et al. Int J Ophthalmol. .

Abstract

Aim: To compare the subjective refraction data with auto-refraction findings in high astigmatisms.

Methods: In a cross-sectional study, sampling was done from in different geographic regions in Iran using a multistage random cluster sampling method. All study participants underwent cycloplegic auto-refraction and subjective refraction using the red-green test.

Results: In this study, 277 eyes of 158 students aged 8 to 15y were analyzed. According to the results, the mean difference between subjective refraction and autorefraction in measuring sphere, cylinder, spherical equivalent, J0, and J45 was -0.18±0.76, -0.36±0.40, -0.36±0.79, 0.15±0.20, and 0.05±0.21 respectively. The correlation of these two refraction methods in measuring the aforementioned indices was 0.963, 0.898, 0.960, 0.931, and 0.948 respectively. The 95% limits of agreement of the two methods in measuring the above indices were -1.66 to 1.31, -1.14 to 0.42, -1.91 to 1.19, -0.24 to 0.54, and -0.36 to 0.47 respectively. The agreement between the two methods decreased with increasing cylinder power, and the best agreement was found in myopic individuals.

Conclusion: The measurements obtained by autorefractometer have a significantly higher cylinder average compared to subjective refraction. However, in the cylinder range of 4-5 diopters, the values of J0 and J45 do not have a high correlation.

Keywords: astigmatism; autorefraction; subjective refraction.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Kangari H, None; Hashemi H, None; Rahmani S, None; Ahmadian E, None; Yekta A, None; Khabazkhoob M, None.

Figures

Figure 1
Figure 1. Scatter plot between subjective refraction and autorefraction measurements of the cylinder power (A), J0 (B), and J45 (C).
Figure 2
Figure 2. Agreement between subjective refraction and autorefraction measurements of the spherical error (A), cylinder power (B), spherical equivalent (C), J0 (D), and J45 (E)
The middle line indicates the mean difference and the two dashed side lines show the 95% limits of agreement.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kanclerz P, Bazylczyk N, Lanca C. The prevalence of astigmatism and spectacle wear in Polish schoolchildren. J Binocul Vis Ocul Motil. 2023;73(4):124–130. - PubMed
    1. Valluru G, Klawe J, Liu B, et al. Characterizing astigmatism in the United States. J Cataract Refract Surg. 2022;48(5):519–527. - PubMed
    1. Hashemi H, Asharlous A, Yekta A, et al. Astigmatism profile in the elderly population: Tehran geriatric eye study. Jpn J Ophthalmol. 2022;66(5):461–473. - PubMed
    1. Hashemi H, Fotouhi A, Yekta A, et al. Global and regional estimates of prevalence of refractive errors: systematic review and meta-analysis. J Curr Ophthalmol. 2018;30(1):3–22. - PMC - PubMed
    1. Fotouhi A, Hashemi H, Ali Yekta A, et al. Characteristics of astigmatism in a population of schoolchildren, dezful, Iran. Optom Vis Sci. 2011;88(9):1054–1059. - PubMed

LinkOut - more resources