A reconsideration of visual evoked potentials for fast automated ophthalmic refractions.

Visual evoked potentials (VEP's) recorded from the scalp are sensitive to retinal image sharpness and thus to changes in the refractive state of the eye. Initially the responses to checkerboard flash or reversal stimuli were computer-averaged in order to raise the signal above the noise, primarily the electroencephalogram (EEG). Recently analogue Fourier signal analysis has been proposed for using the VEP for rapid clinical refraction. We have confirmed that this method can measure the spherical refractive state to within +/- 0.50D. However, because of large slow-wave fluctuations, measurements of changes within +/- 1.00D are not always clear. Despite its promise the method does not appear to be clinically useful at present.