Comparison of self-refraction using a simple device, USee, with manifest refraction in adults

Background The USee device is a new self-refraction tool that allows users to determine their own refractive error. We evaluated the ease of use of USee in adults, and compared the refractive error correction achieved with USee to clinical manifest refraction. Methods Sixty adults with uncorrected visual acuity <20/30 and spherical equivalent between -6.00 and +6.00 diopters completed manifest refraction and self-refraction. Results Subjects had a mean (+/- SD) age of 53.1 (+/- 18.6) years, and 27 (45.0%) were male. Mean (+/- SD) spherical equivalent measured by manifest refraction and self-refraction were -0.90 D (+/- 2.53) and +/- 1.22 diopters (+/- 2.42), respectively (p = 0.001). The proportion of subjects correctable to >= 20/30 in the better eye was higher for manifest refraction (96.7%) than self-refraction (83.3%, p = 0.005). Failure to achieve visual acuity >= 20/30 with self-refraction in right eyes was associated with increasing age (per year, OR: 1.05; 95% CI: 1.00-1.10) and higher cylindrical power (per diopter, OR: 7.26; 95% CI: 1.88-28.1). Subjectively, 95% of participants thought USee was easy to use, 85% thought self-refraction correction was better than being uncorrected, 57% thought vision with self-refraction correction was similar to their current corrective lenses, and 53% rated their vision as "very good" or "excellent" with self-refraction. Conclusion Self-refraction provides acceptable refractive error correction in the majority of adults. Programs targeting resource-poor settings could potentially use USee to provide easy on-site refractive error correction.