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Flow of Refraction Procedure

The ocular refraction procedure starts with an extensive
history taking of the individual and ends with an individualized
prescription and appropriate management provided to him. A
quick and efficient refraction involves a number of procedures
and if done in a logical order, really provides the most predictable
results.



The entire flow of the refraction procedure can be
grouped under three broad categories:
1. Initiating the process
2. Routine procedure
3. Refinement.

The different categories include different techniques but the
aim of all the techniques is to provide a suitable pair of lenses that
will provide the patient clear and comfortable vision to which the
patient will adapt rapidly. It must be kept in mind that refraction
is done for an individual person and not for a pair of eyeballs
which means importance should be given to the results based
on all the techniques including intellectual process involved. In
general the common flow of the refraction procedure is as under:

A. Initiating the Process
1. History taking
2. Lensometry
3. Visual acuity test : UCVA , VAcc, Pinhole Acuity
4. Objective measurement of refractive error: Retinoscopy, Keratometry,
    Autorefractometry
5. Think and go ahead.


B. Routine Procedure
1. Dominant eye test
2. Monocular subjective refraction
3. Determination of near addition
4. Think and go ahead.

C. Refinements
1. Duochrome test
2. Binocular balancing
3. Stop, think and prescribe.

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