Autorefractors

Autorefractors are optical instruments used to measure refractive error of the eye automatically. They provide an objective estimate of a patient's prescription by analyzing how light reflects from the retina and how the eye focuses images on the retina. Modern devices emit an infrared beam, project a fixation target, and compute refractive power from retinal reflections or wavefront data. Some units also estimate keratometry and pupil diameter, and newer models assess higher-order aberrations with wavefront aberrometry.

In operation, the patient looks at a fixation target while the instrument aligns with the eye and records measurements. The device reports a starting prescription in standard terms: sphere, cylinder, and axis. Measurements may be obtained under non-cycloplegic conditions, and cycloplegia is used when accommodation could bias results, especially in children or in hyperopic patients.

Autorefractors come in tabletop/desktop forms for clinics and handheld units for screening or pediatric use. They are typically used to generate a starting point for subjective refraction and to screen for refractive errors; final prescriptions are usually refined with a phoropter or trial lenses.

Advantages include speed, objectivity, and repeatability, improving clinic throughput and providing measurements for difficult cases. Limitations include reduced accuracy for certain errors, eyes with poor fixation, cataracts, or irregular corneas, and the influence of accommodation or optical factors; thus results should be interpreted by a clinician and often corroborated with subjective refraction.