Testing Accommodation in Children

2022 ◽  
pp. 200-221
Author(s):  
Ida Chung
Keyword(s):  
Clinical Setting ◽  
Pediatric Patients ◽  
Burning Sensation ◽  
Accommodative Response ◽  
Eye Pain ◽  
Near Work ◽  
Accommodative Function ◽  
Accommodative Amplitude ◽  
Accommodative Facility

Accommodation disorders are associated with a host of etiologies. Children with accommodative disorders can present with various symptoms including blur, fluctuating vision, eye pain, burning sensation, tired eyes, asthenopia, headaches, fatigue with near work, and excessive rubbing, blinking, or tearing. This chapter provides an overview of accommodation testing on pediatric patients in the clinical setting. The author describes the indications for accommodation testing and provides clinical pearls for testing accommodative function in children. The chapter covers the specific tests, equipment required, and step-by-step procedures for testing accommodative amplitude, accommodative response, and accommodative facility.

scholarly journals Changes in accommodative function following small-incision lenticule extraction for high myopia

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244602
Author(s):  
Anders Gyldenkerne ◽  
Nicolaj Aagaard ◽  
Malene Jakobsen ◽  
Carina Toftelund ◽  
Jesper Hjortdal
Keyword(s):  
High Myopia ◽  
Higher Order ◽  
Mean Difference ◽  
Small Incision Lenticule Extraction ◽  
Higher Order Aberrations ◽  
Accommodative Response ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Accommodative Function ◽  
Accommodative Facility

Purpose To examine whether the amplitude of accommodation, the accommodative response, and the accommodative facility is affected and correlated with changes in higher-order aberrations for patients with high myopia surgically treated with small-incision lenticule extraction (SMILE). Methods 35 highly myopic eyes (myopic spherical equivalent of at least 6 diopters) of 35 patients treated with SMILE were included. Assessments were made before and 3 months after surgery. Donders push-up-method was used to measure the amplitude of accommodation. The accommodative response was assessed using an open-field autorefractor”Grand Seiko WAM-5500” (Grand Seiko Co. Ltd., Hiroshima, Japan) in combination with a Badal optometer and stimuli of accommodation at 0.0, 0.5, 1.25, 2.0, 3.0, and 4.0 D, respectively. Accommodative facility was measured at 40 cm with ±2,00D flipper lenses. All measurements of accommodation were performed monocularly with the refractive error corrected with soft contact lenses. Results The amplitude of accommodation did not change statistically significantly (mean difference -0.24 D (SD 0.98), 95% CI of mean difference -0.58 D to 0.11 D, paired-sample t(34) = -1.39; P = 0.17). The accommodative responses at 0.0, 0.5, 1.25, 2.0, 3.0, and 4.0 D did not statistically significantly change either (F(6,29) = 1.15; P = .36). Finally, the accommodative facility was also unchanged with a mean difference of 1.11 cycles per minute (SD 5.11, 95% CI of mean difference -0.64 to 2.87, paired-sample t(34) = 1.29; P = 0.21). No clinically significant associations between changes in accommodation and higher-order aberrations were found. Conclusions SMILE does not alter the amplitude of accommodation, the accommodative response, nor the accommodative facility for highly myopic patients, and the surgically induced corneal higher-order aberrations do not affect the accommodative function.

scholarly journals Effect of Vision Therapy on Accommodation in Myopic Chinese Children

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
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.

Accommodative amplitude required for sustained near work

2011 ◽  
Vol 31 (5) ◽  
pp. 480-486 ◽  
Author(s):  
James S Wolffsohn ◽  
Amy L Sheppard ◽  
Sanjay Vakani ◽  
Leon N Davies
Keyword(s):  
Near Work ◽  
Accommodative Amplitude

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

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.

scholarly journals PREVALENCE OF EYE DISORDERS IN CHILDREN PRESENTING IN OUTPATIENT DEPARTMENT WITH ASTHENOPIA

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Vijayta Gupta ◽  
Anuj Bhatti
Keyword(s):  
Outpatient Department ◽  
Age Group ◽  
Exclusion Criteria ◽  
Eye Pain ◽  
Prompt Treatment ◽  
Common Complaint ◽  
Eye Disorders ◽  
Group 5 ◽  
24 Hour Recall ◽  
Near Work

Introduction: Asthenopia is a common complaint in school going children. The magnitude of the problem in our region is not known. Methodology: Children (5-18 years) presenting in pediatric and ophthalmology outpatient department with symptoms (defined a proiri) were included in study. Exclusion criteria included BCVA of less than 6/9 in either eye, strabismus, ocular or systemic diseases affecting binocular vision, and using any medication that can impact accommodation or convergence. Previous day 24 hour recall method was used to assess the time spent on various activities. Subsequently, detailed refractive assessment was done. Results: A total of 24200 children with age group 5-18 years visited outpatient department. Out of them 520 (2.1%) children had symptoms of asthenopia. The proportion of males (66.6%) was higher than female (33.4%). The proportion of children with asthenopia increased from 21% in 5-9 year group to 45% in 13-18 year group. Tearing and eye pain were the commonest presenting complaints The presence of four or more symptoms was not observed in 5-9 age group. Asthenopic children spend a mean of 4.2 hours/day on screen. Conclusion: Asthenopia is common eye complaint in school children. It can interfare in near work, so warrants prompt treatment.

scholarly journals Features of accommodation function in contemporary schoolchildren with progressive myopia

2020 ◽  
Vol 20 (5-6) ◽  
pp. 58-62
Author(s):  
Abida Mahdi
Keyword(s):  
High Myopia ◽  
Normal Values ◽  
The State ◽  
Ciliary Muscle ◽  
Control Group ◽  
Accommodative Response ◽  
Progressive Myopia ◽  
Accommodative Function

The purpose of this study is to study the state of accommodative function in contemporary schoolchildren using the method of computer accommodation. We studied 50 children (10-16 years old): 40 with different degrees of myopia and 10 children (control group) with emmetropia. The accommodation was studied with the computer accomodate Righton Speedy-K ver. MF-1. Defined power of accommodative response to accommodative stimulus imposed by calculating a ratio the coefficient of accommodative response (CAR) and the nature of the contraction of the fibers of the ciliary muscle by determining microfluctuations coefficient (CMF). It was found that in groups of patients with emmetropia and weak myopia, the coefficient of accommodation response and the microfluctuation coefficient exceed the average normal values. Especially pronounced changes in the group of children with mild myopia. In groups of children with moderate and high myopia, the CAR is significantly lower than in mild myopia and emmetropia, while the CMF also exceeds normal values.

scholarly journals The Accommodation Response and Facility between Children and Young Adults

2020 ◽  
Vol 5 (14) ◽  
pp. 111-118
Author(s):  
Nur Aresya Ahmad Najmee ◽  
Saiful Azlan Rosli ◽  
Syazwina Batrisya Jalaludin
Keyword(s):  
Young Adults ◽  
Late Onset ◽  
Publishing House ◽  
Estimation Method ◽  
Lag Of Accommodation ◽  
Adults And Children ◽  
International Publishing ◽  
Children And Young Adults ◽  
Near Work ◽  
Accommodative Facility

Tonic accommodation decreased with age among children. In young adults, late-onset myopia will develop due to occupational near vision demands. This study aims to investigate the accommodation response and facility between children and young adults, in emmetrope (non-myopic) and myope group. The accommodation response and facility of young adults and children were measured using monocular estimation method (MEM), monocular accommodative facility (MAF) and binocular accommodative facility (BAF) with an exposure of near task for 15 minutes. Near task has significantly increased the lag of accommodation in all groups (p<0.05). However, the accommodation facility was not affected by near work in all groups (p>0.05). Keywords: accommodation response, accommodation facility, myopes, emmetropes. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i14.2168

Ocular Emergencies in Children

2022 ◽  
pp. 306-358
Author(s):  
Joy Harewood ◽  
Alanna Khattar ◽  
Olivia Bass
Keyword(s):  
Emergency Room ◽  
Acute Care ◽  
Clinical Setting ◽  
Pediatric Patients ◽  
Imaging Techniques ◽  
Routine Care ◽  
Acute Care Setting ◽  
External Examination ◽  
Internal Structures ◽  
Ocular Imaging

This chapter covers general bedside and chairside examination procedures and instruments used to examine a pediatric patient in an acute care setting. Pediatric patients may present to an emergency room or present emergently in any clinical setting with a wide variety of acute ocular conditions. When working in an emergency room or hospital-based setting, it is unlikely that a clinician will have all of the exam equipment typically used for routine care. The authors review the various ocular imaging techniques used to obtain a view of the internal structures of the eye, orbit, head, and brain when external examination is not sufficient. The procedures described aid the clinician in appropriately and thoroughly evaluating pediatric patients presenting with ocular emergencies.

Changes in the Subjective Symptoms and Accommodative Function after Near Work in a Virtual Moving Environment

2019 ◽  
Vol 24 (3) ◽  
pp. 267-277 ◽  
Author(s):  
Jihye Kim ◽  
Won Young Jung ◽  
Minjin Jeong ◽  
Kyeong Chul Lee ◽  
Han Wool Won ◽  
...  
Keyword(s):  
Subjective Symptoms ◽  
Near Work ◽  
Accommodative Function

The Presentation and Management of Individuals Contaminated with Solutions of Dibenzoxazepine (CR)

1973 ◽  
Vol 13 (4) ◽  
pp. 265-268 ◽  
Author(s):  
Bryan Ballantyne ◽  
F. W. Beswick ◽  
D. Price Thomas
Keyword(s):  
Blood Pressure ◽  
Structural Damage ◽  
Control Agent ◽  
Burning Sensation ◽  
Excessive Salivation ◽  
Eye Pain ◽  
The Face ◽  
Conjunctival Vessels ◽  
Riot Control

Dibenz(b. f)-1, 4-oxazepine (CR) is a highly potent irritant to both the eyes and skin of man; it is more potent than the riot control agent chloracetophenone although apparently less toxic. Observations have been made on the effects of CR in weak solutions (up to 0.1 per cent) on more than 150 volunteers. Splashed on to the face these solutions cause pain, blepharospasm, and lacrimation lasting about twenty minutes, a transient injection of conjunctival vessels, and erythema of the lid margins; there is no structural damage to the eye. There is a burning sensation in affected skin, and a well delineated erythema; sensitization does not occur. Solution entering the mouth causes a short-lived burning sensation, excessive salivation, sore throat, and rhinorrhoea. The general acute discomfort causes a transient increase in blood-pressure. These short-lived effects are unaccompanied by the risks for long-term damage, such as may occur with the use of chloracetophenone. Treatment is palliative and includes reassurance, removal of contaminated clothing, washing of the eyes and skin; eye pain can be relieved with amethocaine.

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