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Editorial Spotlight | Jun 2016

Handheld Autorefractors

The versatility and convenience of these devices make them ideal for teleophthalmology settings.

There are important applications for a handheld autorefractor in the clinical setting. A portable but powerful handheld autorefractor such as the SVOne (Smart Vision Labs; Figure 1) can be used in place of a desktop unit if, for instance, the desktop unit malfunctions or needs servicing. The SVOne adds flexibility to the clinic because it is transportable. This can improve patient flow dynamics, taking the testing modality to the patient rather than having the patient leave the exam room to go to a testing station. A handheld autorefractor serves to relieve bottlenecks if a testing station is occupied; it also allows clinicians to carry the technology to satellite offices that may not have the same diagnostic equipment as the main office.

Figure 1. The SVOne Pro in use in the clinic (A-C).

Where a handheld autorefractor such as the SVOne could have its greatest impact, however, is in teleophthalmology settings. In certain rural areas, there are coverage gaps where patients often have to travel great distances to be seen by an eye care provider. Using the SVOne, which is a Hartmann-Shack wavefront sensor affixed to an iPhone, it would not take much to design a protocol to remotely screen patients to detect refractive errors in need of follow-up.

Smart Vision Labs recently released updated versions of this technology called SVOne Pro and SVOne Enterprise. Among other features, these versions provide the ability for patients to take readings themselves; such versatility adds to the potential to use these devices in remote settings.

I participate in a mission trip every year to Grenada in partnership with St. George’s University. Each time we go, we bring surgical supplies and medicines in addition to the luggage we carry as individuals. Hauling the equipment we need to deliver appropriate eye care creates real logistic challenges. The beauty of the SVOne is that I can put it in my suitcase and, at the expense of carrying less than 2 pounds, I have with me a powerful, verified autorefractor.

The second-generation SVOne Pro automatically captures the patient’s refraction after averaging three readings, instead of five with the previous model. The company is also looking for other ways to enhance the potential for remote screening.

A new offering from Smart Vision Labs called Enterprise serves as an on-demand prescription service. In effect, this is a natural extension of the self-guided autorefractor concept: The patient performs a self-guided examination, and that data is shared with an eye care professional over the cloud and then passed along to a provider who makes the required glasses or contact lenses.

Bernard Spier, MD, FAAO
• Private practice, The Northern New Jersey Eye Institute
• Clinical Instructor, Rutgers Medical School, New Jersey
• Financial disclosure: Consultant (Smart Vision Labs)