Tunable lenses, optical elements able to change their optical power within milliseconds, constitute an emerging technology increasingly used in ophthalmic applications. In this study, 25 subjects looked through tunable lenses at a chromatic stimulus to evaluate the perceptual response of the human visual system to periodic changes in defocus of 0.25D of amplitude and 15 Hz of temporal frequency. These defocus changes produce flicker and chromatic distortions that change with the overall level of defocus. The task in this study was to minimize the flicker by varying the average optical power, and it was performed for different myopic and hyperopic starting points. Subjects also performed a blur-minimization task in a black-and-white stimulus of the same geometry. The flicker-minimization task is more repeatable than the blur-minimization task (standard deviations ±0.17D and ±0.49D). The time per repetition of the flicker-minimization task is only 38s. Cycloplegia severely affects the blur-minimization, but not the flicker-minimization task, confirming that defocus flicker deactivates the accommodative system. This discovery can be used to develop new methods for measuring the refractive error of the eye that does not require supervision and can potentially improve existing subjective methods in terms of accuracy, precision, and measurement time.

We present the Direct Subjective Refraction (DSR), a new subjective refraction method, and validate it vs the Traditional Subjective Refraction (TSR) and an unsupervised version of it (UTSR). We project an optotunable lens onto the eye to create Temporal Defocus Waves produces flicker and chromatic distortions, minimum when the mean optical power of the wave matches the spherical equivalent of the eye. 25 subjects performed the DSR visual and UTSR tasks without supervision. DSR is more repeatable than TSR and UTSR (standard deviations ±0.17D, ±0.28, and ±0.47D). The time per repetition of DSR is only 39s (almost 6 min for TSR). Cyclopegia severely affects UTSR, but not DSR, confirming that the DSR task de-activates the accommodative system. DSR is a new method to obtain the spherical equivalent that does not requires supervision and overpasses existing subjective methods in terms of accuracy, precision, and measurement time.