The literature in the past year on refraction is replete with several isolated but very important topics that have been of interest to strabismologists and refractionists for many decades. The refractive changes in scleral buckling procedures include an increase in axial length as well as an increase in myopia, as would be expected. Tinted lenses in dyslexia show little positive effect in the nonasthmatic patients in one study. The use of spectacles or bifocals as a way to control increase in myopia is refuted in another report. It has been shown that in accommodative esotropia not all patients will be able to escape the use of bifocals in the teenage years, even though surgery might be performed. The hope that disposable contact lenses would cut down on the instance of giant papillary conjunctivitis and keratitis has been given some credence, and the conventional theory that sclerosis alone is the cause of presbyopia is attacked. Also, gas permeable bifocal contact lenses are reviewed and the difficulties of correcting presbyopia by this method outlined. The practice of giving an aphakic less bifocal addition instead of a nonaphakic, based on the presumption of increased effective power, is challenged. In the review of prisms, the majority of articles concern prism adaptation. The most significant report is that of the Prism Adaptation Study Research Group (Arch Ophthalmol1990, 108:1248–1256), showing that acquired esotropia in particular has an increased incidence of stable and full corrections surgically in the prism adaptation group versus the control group. Other studies show that adaptation in refractive errors is similar, and the pattern of prism adaptation in normosensory strabismus, cerebellar dysfunction, and in patients with Parkinson's disease is reported. One study shows that measurement of fusion ranges by prisms versus other methods yields different types of information and that fusion with prisms cannot be compared with other methods. The Fresnel versus other conventional prism corrections and the advantages and disadvantages of each are reviewed, along with the aberrations in the two methods of correction.