Purpose The purpose of this study was to compare the reliability and acceptability of tele-controlled subjective refraction supported by RDx, a new technique that involves optical software designed for controlling phoropters remotely, to traditional subjective refraction. Methods Sixty-five participants underwent tele-controlled subjective refraction and traditional subjective refraction randomly and nine of them underwent the second tele-controlled subjective refraction measurement on the same day. After their examinations, we distributed a validated satisfaction questionnaire to each participant. The elapsed time taken for refraction, sphere (S), cylinder (C), spherical equivalent (SE), vertical and oblique cylindrical vectors (J 0 and J 45 ), and best corrected visual acuity (BCVA) were compared. Age and refractive error type were included as covariates. Bland-Altman analysis was used to assess the agreement between both methods of refraction. Results The mean age was 20.5 ± 5.9 years for all participants (aged 9 to 40 years); 57% were female participants. The repeatability analysis of tele-controlled method showed no significant differences for all parameters ( P > 0.05). We found no statistical differences ( P > 0.05) between tele-controlled subjective refraction and traditional subjective refraction for all parameters in either group. The mean difference and 95% limits of agreement for SE, J 0 , and J 45 were −0.03 ± 0.36 diopters (D), −0.00 ± 0.57 D, and −0.01 ± 0.79 D, respectively. The tele-controlled method took more time to perform than the traditional one ( P < 0.05). Completed questionnaires were returned by 55 participants (85%), and they showed high satisfaction and acceptance of the tele-controlled method (98%). Conclusions Tele-controlled subjective refraction results agreed with traditional subjective refraction for all refraction components except for cylinder vectors. In addition, the broad acceptability of tele-controlled subjective refraction means practicability in clinical practice. Translation Relevance The RDx-based tele-controlled method can provide an alternative to subjective refraction, especially in areas that lack experienced optometrists.
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