Comparison of Dynamic Retinoscopy and Autorefraction for Measurement of Accommodative Amplitude

PurposeTo evaluate the effects of 0.01% and 0.02% atropine eye drops on myopia progression, pupil diameter and accommodative amplitude in myopic children.MethodsA cohort study assessed 400 myopic children divided into three groups: 138 and 142 children were randomised to use either 0.02% or 0.01% atropine eye drops, respectively. They wore single-vision (SV) spectacles, with one drop of atropine eye drop applied to both eyes once nightly. Control children (n=120) only wore SV spectacles. Repeated measurements of spherical equivalent refractive errors (SERs), axial length (AL), pupil diameter and accommodative amplitude were performed at baseline, and 4, 8 and 12 months after treatment.ResultsAfter 12 months, the SER change was −0.38±0.35D, −0.47±0.45D, −0.70±0.60D and AL change was 0.30±0.21 mm, 0.37±0.22 mm, 0.46±0.35 mm in the 0.02%, 0.01% atropine and control groups, respectively. There were significant differences in the change in AL and SER between three groups (all p<0.001). Between baseline and the 12-month visit, the overall change in accommodative amplitude was 1.50±0.25D, 1.61±0.31D and change in pupil diameter was 0.78±0.42 mm, 0.69±0.39 mm, with 0.02% and 0.01% atropine, respectively. Accommodative amplitude significantly decreased and pupil diameter significantly increased in two atropine groups (all p<0.001). Moreover, there was no statistical difference in the change difference in accommodative amplitude and pupil diameter between two atropine groups (p=0.24, p=0.38), whereas the accommodative amplitude (p=0.45) and pupil diameter (p=0.39) in the control group remained stable.Conclusions0.02% atropine eye drops had a better effect on myopia progression than 0.01% atropine, but 0.02% and 0.01% atropine showed similar effects on pupil diameter and accommodative amplitude after 12 months of treatment.Trial registration numberChiCTR-IPD-16008844.

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On the relationship between lens stiffness and accommodative amplitude

Experimental Eye Research ◽

10.1016/j.exer.2007.07.012 ◽

2007 ◽

Vol 85 (5) ◽

pp. 602-607 ◽

Cited By ~ 41

Author(s):

Henk A. Weeber ◽

Rob G.L. van der Heijde

Keyword(s):

The Relationship ◽

Accommodative Amplitude

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Subjective and objective measurement of human accommodative amplitude

Journal of Cataract & Refractive Surgery ◽

10.1016/s0886-3350(03)00667-9 ◽

2003 ◽

Vol 29 (10) ◽

pp. 1878-1888 ◽

Cited By ~ 84

Author(s):

Jon E. Wold ◽

Annie Hu ◽

Stephanie Chen ◽

Adrian Glasser

Keyword(s):

Objective Measurement ◽

Accommodative Amplitude

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Accommodative amplitude required for sustained near work

Ophthalmic and Physiological Optics ◽

10.1111/j.1475-1313.2011.00847.x ◽

2011 ◽

Vol 31 (5) ◽

pp. 480-486 ◽

Cited By ~ 10

Author(s):

James S Wolffsohn ◽

Amy L Sheppard ◽

Sanjay Vakani ◽

Leon N Davies

Keyword(s):

Near Work ◽

Accommodative Amplitude

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(OR-127)MEASUREMENT OF HUMAN ACCOMMODATIVE AMPLITUDE

Optometry and Vision Science ◽

10.1097/00006324-200012001-00308 ◽

2000 ◽

Vol 77 (SUPPLEMENT) ◽

pp. 185

Author(s):

Jon Wold ◽

Annie Hu ◽

Adrian Glasser

Keyword(s):

Accommodative Amplitude

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Accommodative amplitude using the minus lens at different near distances

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_545_16 ◽

2017 ◽

Vol 65 (3) ◽

pp. 223 ◽

Cited By ~ 2

Author(s):

Hamed Momeni-Moghaddam ◽

JasonS Ng ◽

BrunoMario Cesana ◽

AbbasAli Yekta ◽

MohammadReza Sedaghat

Keyword(s):

Accommodative Amplitude

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Amplitude, facility and accuracy of accommodation in a primary school population

African Vision and Eye Health ◽

10.4102/aveh.v68i4.196 ◽

2008 ◽

Vol 68 (4) ◽

Author(s):

V. R. Moodley

Keyword(s):

Primary School ◽

Study Data ◽

Vision Screening ◽

Microsoft Excel ◽

School Population ◽

School Vision ◽

School Career ◽

Visual Problems ◽

Accommodative Amplitude ◽

Accommodative Facility

Vision screening at an early age in children is important as it can identify aspects in the visual system that may need to be managed to enable a child to function optimally at school. The National School Vision Screening Programme was discontinued in many provinces of South Africa, often due to a lack of financial resources or adequately trained personnel. This action has resulted in the majority of children not having a visual examination during their school career. In a few instances where vision screenings are performed, these are usually limited to visual acuity (VA) evaluation alone; an endeavour that may miss many significant visual problems. The purpose of this article is to highlight the need for vision screening to be conducted in schools and for the screening protocols to include the various accommodative tests. A retrospective analysis of the amplitudes of accommodation, accommodative facility and accuracy of accommodation findingsfrom a primary school vision screening of 264 children between 6 and 13 years was undertaken in this study. Data was captured and analysed with Microsoft Excel. The ages of the children ranged from 6 to 13 years with a mean of 9.38 years (SD = 1.85). One hundred and thirty eight (52.3%) were males and 126 (47.7%) females. A significant number of the children failed the monocular accommodative amplitude tests (24%), binocular accommodative amplitude test (26%), the accommodative facility (30%) and the MEM test (27%). These results highlight the need for a more comprehensive vision screening exercise rather than VA alone as this approach would have missed more than a quarter of the children who had other visual problems that could impact on their ability to perform optimally at school.

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Effect of Vision Therapy on Accommodation in Myopic Chinese Children

Journal of Ophthalmology ◽

10.1155/2016/1202469 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Martin Ming-Leung Ma ◽

Mitchell Scheiman ◽

Cuiyun Su ◽

Xiang Chen

Keyword(s):

Confidence Interval ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Myopia Progression ◽

Baseline Visit ◽

Lag Of Accommodation ◽

Vision Therapy ◽

Accommodative Function ◽

Accommodative Amplitude ◽

Accommodative Facility

Introduction. We evaluated the effectiveness of office-based accommodative/vergence therapy (OBAVT) with home reinforcement to improve accommodative function in myopic children with poor accommodative response.Methods. This was a prospective unmasked pilot study. 14 Chinese myopic children aged 8 to 12 years with at least 1 D of lag of accommodation were enrolled. All subjects received 12 weeks of 60-minute office-based accommodative/vergence therapy (OBAVT) with home reinforcement. Primary outcome measure was the change in monocular lag of accommodation from baseline visit to 12-week visit measured by Shinnipon open-field autorefractor. Secondary outcome measures were the changes in accommodative amplitude and monocular accommodative facility.Results. All participants completed the study. The lag of accommodation at baseline visit was 1.29 ± 0.21 D and it was reduced to 0.84 ± 0.19 D at 12-week visit. This difference (−0.46 ± 0.22 D; 95% confidence interval: −0.33 to −0.58 D) is statistically significant (p<0.0001). OBAVT also increased the amplitude and facility by 3.66 ± 3.36 D (p=0.0013; 95% confidence interval: 1.72 to 5.60 D) and 10.9 ± 4.8 cpm (p<0.0001; 95% confidence interval: 8.1 to 13.6 cpm), respectively.Conclusion. Standardized 12 weeks of OBAVT with home reinforcement is able to significantly reduce monocular lag of accommodation and increase monocular accommodative amplitude and facility. A randomized clinical trial designed to investigate the effect of vision therapy on myopia progression is warranted.

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