Refraction test

This test is performed by an ophthalmologist or optometrist. Both of these professionals are often called “eye doctor.”

You sit in a chair that has a special device (called a phoropter or refractor) attached to it. You look through the device and focus on an eye chart 20 feet (6 meters) away. The device contains lenses of different strengths that can be moved into your view. The test is performed one eye at a time.

The eye doctor performing the test will ask if the chart appears more or less clear when different lenses are in place.

If you wear contact lenses, ask the doctor if you need to remove them and for how long before the test.

There is no discomfort.

This test can be done as part of a routine eye exam. The purpose is to determine whether you have a refractive error (a need for glasses or contact lenses).

For people over age 40 who have normal distance vision but difficulty with near vision, a refraction test can determine the right power of reading glasses.

If your uncorrected vision (without glasses or contact lenses) is normal, then the refractive error is zero (plano) and your vision should be 20/20.

A value of 20/20 is a normal vision. This means you can read 3/8-inch (1 centimeter) letters at 20 feet (6 meters). A small type size is also used to determine normal near vision.

You have a refractive error if you need a combination of lenses to see 20/20. Glasses or contact lenses should give you good vision. If you have a refractive error, you have a “prescription.” Your prescription is a series of numbers that describe the powers of the lenses needed to make you see clearly.

If your final vision is less than 20/20, even with lenses, then there is probably another, non-optical problem with your eye.

The vision level you achieve during the refraction test is called the best-corrected visual acuity (BCVA).

Abnormal results may be due to:

• Astigmatism (abnormally curved cornea causing blurred vision)
• Hyperopia (farsightedness)
• Myopia (nearsightedness)
• Presbyopia (inability to focus on near objects that develops with age)

Other conditions under which the test may be performed:

• Corneal ulcers and infections
• Loss of sharp vision due to macular degeneration
• Retinal detachment (separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers)
• Retinal vessel occlusion (blockage in a small artery that carries blood to the retina)
• Retinitis pigmentosa (damage of the retina)

There are no risks with this test.

You should have a complete eye examination every 3 to 5 years if you have no problems. If your vision becomes blurry, worsens, or if there are other noticeable changes, schedule an exam right away.

After age 40 (or for people with a family history of glaucoma), eye exams should be scheduled at least once a year to test for glaucoma. Anyone with diabetes should also have an eye exam at least once a year.

People with a refractive error should have an eye exam every 1 to 2 years, or when their vision changes.

Eye test – refraction; Vision test – refraction; Refraction

American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation — 2010. Available at: one.aao.org/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation–octobe. Accessed February 26, 2015.

American Academy of Ophthalmology Refractive Management/Intervention Panel. Preferred Practice Pattern Guidelines. Refractive Errors & Refractive Surgery Summary Benchmark — 2014. Available at:one.aao.org/summary-benchmark-detail/refractive-errors–surgery-summary-benchmark-octob. Accessed February 26, 2015.

Kaufman JH. Subjective refraction: fogging and use of the astigmatic dials. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 1;chap 39.