Real world data on digital remote refraction in a healthy population of 14,680 eyes

Refractive errors are the leading cause of preventable visual impairment, to which web-based remote refraction could contribute. We report real-world 2021-2022 data of the underlying algorithm and validated these to conventional prescriptions among healthy individuals (high visual acuity and satisfactied current refraction). Participants were 18-45 years with a spherical (S) error between -3.50 + 2.00S to -2.00 Diopter Cylinder (DC), reported as Spherical Equivalent (SEQ) in mean differences and 95% Limits of agreement. Consecutive measurements (n = 14,680) were assessed of which n = 6386 selected for validation. The mean difference was 0.01D(SD 0.69) and -0.73D(SD 0.92) for myopes and hyperopes respectively. This algorithm shows variation, nonetheless, 67% and 82% of myopes were within +/- 0.5 and +/- 0.75D. The test underestimates hyperopes (34% and 50% within +/- 0.5D and +/- 0.75D) and had inconsistencies distinguishing hyperopia. This proof-of-concept shows home testing has the potency to increase accessibility to care by delivering a valuable alternative for uncomplicated refractive assessments.