{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:19:45Z","timestamp":1787750385028,"version":"build-2784847793"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Accurate and accessible autorefractors are essential for refractive error assessment, particularly in resource-limited settings. This study evaluates the accuracy and reliability of Instaref R20 with a light barrier (Instaref R20 LB) compared to a tabletop autorefractor (AR) and subjective refraction (SR) in an adult population. A light barrier (wearable polaroid filter) was used to reduce ambient illumination and stabilize pupil size, thereby improving measurement reliability under bright conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective study was conducted at a tertiary eye institute in Mumbai, enrolling 200 adults (mean age: 44.33 \u00b1 13.97 years). All the participants underwent a comprehensive eye examination including objective refraction, subjective acceptance, and anterior and posterior segment evaluation. Non-cycloplegic refraction was assessed using Instaref R20, Instaref R20 LB, AR, and SR. Agreement between methods was analyzed using Bland\u2013Altman plots, assessing power vector components (M, J0, J45). Statistical comparisons were performed using the Wilcoxon signed-rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Instaref R20 LB demonstrated strong agreement with SR (M: 0.10D,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.13; J0: -0.05D,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.05; J45: 0.01D,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.44), while Instaref R20 showed slight variance (M: 0.17D,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The agreement within \u00b1 0.50D of SR was 64.64% (M), 85.35% (J0), and 89.39% (J45). Under bright illumination, Instaref R20 failed to capture readings in six cases, whereas Instaref R20 LB obtained stable measurements in all participants, demonstrating superior reliability in bright environments. Subgroup analysis showed higher accuracy in myopic eyes, while AR exhibited significant deviations in hyperopes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The Instaref R20 LB improves measurement accuracy and reliability, particularly under bright illumination. Its strong agreement with SR and portable design make it a viable tool for refractive error assessment in resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1003_25","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:05:02Z","timestamp":1782749102000},"page":"1067-1072","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effect of light barrier and type of refractive error on the performance of a portable wavefront aberrometer-based auto refractometer"],"prefix":"10.4103","volume":"74","author":[{"given":"Maneck","family":"Nicholson","sequence":"first","affiliation":[{"name":"Department of Public Health, Shantilal Shanghvi Eye Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritik","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Public Health, Shantilal Shanghvi Eye Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shonraj Ballae Ganesh","family":"Rao","sequence":"additional","affiliation":[{"name":"Clinical Research, Remidio Innovative Solutions Pvt Ltd, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti","family":"Damani","sequence":"additional","affiliation":[{"name":"Clinical Research, Remidio Innovative Solutions Pvt Ltd, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"R1-20260630","doi-asserted-by":"crossref","first-page":"577","DOI":"10.4103\/ijo.IJO_762_19","article-title":"The burden of uncorrected refractive error","volume":"67","author":"Honavar","year":"2019","journal-title":"Indian J 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autorefractor","volume":"92","author":"Durr","year":"2015","journal-title":"Optom Vis Sci"},{"key":"R13-20260630","doi-asserted-by":"crossref","first-page":"4281","DOI":"10.2147\/OPTH.S387831","article-title":"Validation of a simple-to-use, affordable, portable wavefront aberrometry-based auto refractometer in a paediatric population","volume":"16","author":"Rao","year":"2022","journal-title":"Clin Ophthalmol"},{"key":"R14-20260630","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1186\/s12886-022-02684-5","article-title":"Validation of a simple-to-use, affordable, portable, wavefront aberrometry-based auto refractometer in the adult population: A prospective study","volume":"22","author":"Rao","year":"2022","journal-title":"BMC Ophthalmol"},{"key":"R15-20260630","doi-asserted-by":"crossref","first-page":"e4596","DOI":"10.1097\/MD.0000000000004596","article-title":"A comparison of the Plusoptix S09 with an autorefractometer of noncycloplegics and cycloplegics in children","volume":"95","author":"Won","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"R16-20260630","first-page":"108","article-title":"Comparison of adult refractive disorder measurements using HandyRef-K, retinomax, plusoptix, and table-top autorefractometer devices","volume":"6","author":"Seymen","year":"2021","journal-title":"Beyoglu Eye J"},{"key":"R17-20260630","first-page":"2988","article-title":"Comparison of the VISX wavescan and OPD-scan III with the subjective refraction","volume":"20","author":"Zhu","year":"2016","journal-title":"Eur Rev Med Pharmacol Sci"}],"container-title":["Indian Journal of 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