Exact(8)
When pupil diameter increased to 6 mm, this bias changed in the myopic direction and the variability between metrics also increased.
Automated refraction without cycloplegia, by contrast, resulted in a more negative mean power, indicating inaccuracy in the myopic direction from accommodation.
15 We have found a tendency towards more error in the myopic direction in self refraction compared with subjective refraction among hyperopic participants.
This would increase surface power and, if accompanied by a decrease in p would lead to a change of refraction in the myopic direction.
This result was significantly lower than the corresponding figure of 11%% (all were in the myopic direction) for automated refraction compared with subjective refraction (P<0.001, Wilcoxon signed rank test).
The mean progression of refractive error in the myopic direction was significantly lower in the intervention group than in the control group (-0.10 ± 0.65 D/year vs. -0.27 ± 0.52 D/year, P = 0.005).
With the nuclear region depleted of mobile molecules, those in the surface layers would continue to move out of the lens, making the index gradient less steep in the outer part of the lens and moving the refraction back in the myopic direction, until a new equilibrium index distribution was established.
Additionally, it can reasonably be argued that the assumption that the original index profile is "normal" is unlikely to be correct and that the refraction of the diabetic patient with hyperglycemia has already shifted in the myopic direction as a result of the high blood glucose levels.
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