Comparing Close-Field and Open-Field Autorefractometry and Subjective Refraction

Background/Objectives: Autorefractometers are valuable tools in clinical practice, but their accuracy is often questioned, especially in the pediatric population. This study aimed to compare refraction data from open-field and close-field autorefractometers and subjective refraction without using cycloplegia. Methods: A total of 50 eyes of 50 participants (19 males and 31 females, 11.8 ± 1.56 years) were evaluated. In a single visit, objective refraction was performed using NVision-K 5001 (open-field) and Visionix VX120 (close-field) autorefractometers, and subjective refraction using the fogging technique. Differences between procedures were assessed for sphere, spherical equivalent, and cylindrical vectors J0 and J45 using the Friedman test, followed by the post hoc Wilcoxon test as needed. Results: Significant differences were found in the sphere between the three procedures (all p ≤ 0.032). For the spherical equivalent, the Visionix VX120 differed significantly with the other two techniques (both p < 0.001), whereas no significant differences were found between NVision-K 5001 and subjective refraction (p = 0.193). Finally, no significant differences were observed for J0 and J45 vectors among the procedures (both p ≥ 0.166). Conclusions: There are certain discrepancies between autorefractometers and the subjective assessment of refractive error, most evident in measurements taken with the close-field device, possibly due to greater accommodative stimulation. However, in contexts such as visual screening or as a preliminary guide in the clinic, the values obtained by autorefractometry can provide useful information.