Purpose: Accommodative anomalies are a group of different visual problems that reduce the efficiency of the visual system. Binocular accommodative facility (BAF) therapy is used to train the ability of the eye to repeatedly change its accommodative state when changing focus between two focal planes during periods of time. The aim of this study was to evaluate the effect of BAF training with standard flipper dioptric treatments on a group of non-symptomatic young adults. Material and methods: 67 subjects were recruited among students attending the Optometry Clinic of the Optometry Faculty (USC, Spain). All of them had good general health and were free of any accommodative or binocular problems. Subjects were scheduled to four session one-week apart. In each session, they were requested to measure the BAF in cycles/minute (cpm) with a ±2.00D flipper while focusing a near test at 40 cm. Patients were also requested to point the difficulty for clearing with the minus, plus or with none pair of lenses. Results: There was found a statistical difference on BAF between the first and the final session when the whole sample was analysed (paired t-test: p <0.001), and when the sample was grouped by lens clearing difficulties (paired t-test: all p ≤0.005). BAF showed a statistically significant difference between results obtained in each session (ANOVA: p =0.002), and between the results of contiguous paired sessions (paired t-test: all p ≤0.047). Conclusion: The present study showed the positive effect of traditional dioptric training in amplitude flexibility improvement.
Purpose: Tear film meniscus evaluation offers a non-invasive indication of the total volume of the tear. The aim of this study was to analyse the relationship between the central tear meniscus area with symptomatology and tear film stability. Material and methods: 120 participants who completed an OSDI questionnaire were enrolled in the study. After fluorescein instillation, two videos were recorded by a digital camera attached to a slit-lamp. The first video recorded the lower central portion of the tear meniscus (6 o'clock) with a short light beam (3x5mm), and the second one recorded the complete ocular surface obtaining the Break-Up time (BUT) and Maximum Blink Interval (MBI). A self-design program (FWCapture) was used to acquire the videos while the participants were requested to keep the eye open for as long as possible three times. Images were extracted from each video by a masked observer. From de first video, Central Tear Meniscus Area with fluorescein (CTMAF) was "manually" measured by using ImageJ software (command ">>freehand tool"). From the second video, BUT and MBI were determined by counting video frames then converted in seconds; both parameters were averaging using only the two most similar measurements. Results: CTMAF showed a negative correlation with OSDI score (Spearman Rho: p <0.001, r=-0.372). There was found a statistical difference in the CTMAF between OSDI subgroups (Kruskal-Wallis: p=0.001). CTMAF showed a positive correlation with BUT/MBI (Spearman Rho: both p ≤0.003, r≥0.246). Conclusions: Tear film volume showed a relationship with the symptomatology and tear film stability.
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