Utilization of a self-refracting system on the streets to improve vision in an urban unhoused population.

Mean binocular visual acuity improved from 20/64 to 20/31.

Pinhole visual acuity alone (AUC: 0.74), cylinder alone (AUC: 0.67), and their combination (AUC: 0.81) predicted USee failure.

A pinhole visual acuity worse than 20/60 had sensitivity 0.667, specificity 0.819 (positive likelihood ratio, LR⁺: 3.69, negative likelihood ratio, LR⁻: 0.41).

A cylinder threshold less than - 0.5 diopters (D) had sensitivity 0.346, specificity 0.511 (LR⁺: 0.71, LR⁻: 1.28).