The World Health Organization-endorsed rapid assessment of avoidable blindness (RAAB) survey employs pinhole acuity to distinguish between refractive error versus conditions not correctable with eyeglasses, but few studies have validated this approach [1].

Ethical committees at the University of California, San Francisco and Narayana Nethralya Eye Hospital approved this study. A consecutive series of patients aged ≥50 years visiting the refraction clinic at Narayana Nethralaya Eye Hospital (Bangalore, India) in September 2015 had presenting vision and pinhole vision assessed using an ETDRS chart in a fully illuminated room, and then had a manifest refraction by an experienced optometrist. Analyses are reported with bootstrapped 95% confidence intervals with resampling at the participant level to account for non-independence of eyes.

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