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Subjective Refraction is a technique to determine the combination of lenses that will provide the best corrected visual acuity (BCVA). [1] It is a clinical examination used by orthoptists , optometrists and ophthalmologists to determine a patient's need for refractive correction, in the form of glasses or contact lenses.
A subjective refraction requires responses from the patient. Typically, the patient will sit behind a phoropter or wear a trial frame and look at an eye chart. The eye care professional will change lenses and other settings while asking the patient for feedback on which set of lenses give the best vision.
Following that "objective refraction" the clinician typically shows the person lenses of progressively higher or weaker powers in a process known as subjective refraction. Cycloplegic agents are frequently used to more accurately determine the amount of refractive error, particularly in children [23]
Jackson cross cylinder of +/- 0.25 diopter. Jackson cross cylinder is a single low power lens, which is a combination of a plus cylinder and a minus cylinder of equal power with axis perpendicular to each other, with a handle placed between the two axes at 45 degrees.
Retinoscopy is particularly useful in prescribing corrective lenses for patients who are unable to undergo a subjective refraction that requires a judgement and response from the patient (such as children or those with severe intellectual disabilities or communication problems).
A diagnosis of far-sightedness is made by utilizing either a retinoscope or an automated refractor-objective refraction; or trial lenses in a trial frame or a phoropter to obtain a subjective examination.
Although phoropters, which contains lenses allow a quicker refraction, the trial frame help to test near vision at the patient's preferred working distance and position. [1] Since it is portable, a trial frame is ideal for vision and refraction screening during home (domiciliary) visits and outreach camps.
A duochrome test is a test commonly used to refine the final sphere in refraction (undercorrection and overcorrection), which makes use of the longitudinal chromatic aberration of the eye. Because of the chromatic aberration of the eye, the shorter wavelengths (green) are focused in front of the longer red wavelengths.