Effect of Wavefront Autorefractor Design on Cycloplegic Refraction in Young Hyperopes: Monocular vs. Binocular

Abstract

Objectives: To compare the objective refraction of young hyperopes obtained by two wavefront autorefractors with identical measurement principles but different optical designs: a monocular closed-field (VX 120) and a binocular open-field (Eye Refract), both developed by the same manufacturer (Visionix; Pont-de-l’Arche, France). Methods: A randomized, cross-sectional study was carried out with 37 hyperopic participants (18.2 ± 7.8 years; range 8 to 31 years). Each participant underwent two measurement sessions (one with and one without cycloplegia), during which three measurements were taken per autorefractor (monocular and binocular). Refractive variables (M, J0, and J45) were analyzed in one randomly selected eye. Results: The spherical equivalent (M) showed significant differences between autorefractors under noncycloplegic and cycloplegic conditions (p < 0.001). Without cycloplegia, the binocular autorefractor measured +0.45 (+1.49, −0.58) D more hyperopia than the monocular device. Under cycloplegia, this difference decreased to +0.26 D (+0.99, −0.48) D. Both autorefractors provided higher hyperopia with cycloplegia, with differences inversely correlated with age (r = −0.4; p < 0.05). Conclusions: Whenever possible, refraction in young hyperopes should be measured under cycloplegic conditions using a binocular open-field autorefractor to promote greater accommodative relaxation and ensure more reliable hyperopia measurements in both clinical practice and research.