Zeitschrift für klinische und experimentelle Ophthalmologie
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Tele-Refraction in Tele-Eye Care Settings: A Commentary

Nicolas Blais*, Benoit Tousignant, Jean-Marie Hanssens

Uncorrected refractive errors are the leading cause of visual impairment globally. The access to primary eye care, which includes refraction, is limited by the lack of refractionists and the remoteness of certain populations. Remote refraction could be a promising way to address this issue. There are two types of remote refraction: web-based refraction testing and clinical tele-refraction. Online refraction is the use of web-based tools or devices that allow for subjective refractive measurements. This type of remote refraction is unassisted, while clinical tele-refraction involves an in-person technician, or professional, and a remote eye care provider in a synchronous, asynchronous or hybrid modality. Studies have found that both online refraction and clinical tele-refraction can be equivalent to in-person subjective refraction. Tele-refraction also appears to have an excellent ability to fully address eye complaints for uncorrected refractive errors and presbyopia. Tele-eye care is evolving quickly and more studies on remote refraction are still needed to safely outline its role and to precise clinical guidelines. In order to provide comprehensive primary eye care examinations remotely instead of being limited to refractive-only or disease-specific screening, further research in the remote assessment of binocular vision and ocular health are also necessary.