Association Between Accommodative Amplitudes and Amblyopia

Abstract

Purpose To evaluate the relationship between amblyopia and accommodative ability. Methods The open-field Grand Seiko binocular autorefractor has become the gold standard for automated measurement of static accommodation. We measured the accommodation amplitudes in 52 children ages 3 to 14 years employing the Grand Seiko auto refractor. Children wore their glasses for this test, which was prescribed based on a cycloplegic refraction performed by one pediatric ophthalmologist. No readings could be obtained for 9 eyes (5 patients). Results Normal accommodation with correction utilizing full accommodative effort at 1/3 meter is 3D assuming no accommodative lag, and would generate a reading of −3.00D from the Grand Seiko auto refractor. Lack of any accommodative should give a reading of 0.00D. Accommodative gradually declined as the acuity worsened. Conclusion Our results suggest that amblyopic eyes do not accommodate as well as non-amblyopic eyes. Because accommodation amplitude is not subjective it may be a more sensitive indicator of regression of amblyopia than visual acuity. The Grand Seiko autorefractor could prove to be a useful tool to monitor the progress of patients with amblyopia.

Longitudinal Evaluation of Accommodation During Treatment for Unilateral Amblyopia

“…4 ). Beyond any impact of measurement error or eccentric and unsteady fixation, 5 there are a number of potential mechanistic theories about this relationship. For example, in the extreme, poor accommodative performance related to poor amblyopic eye VA could result in a poorly focused retinal image during patching treatment, which could then limit the improvement in VA, and so both accommodative performance and VA would stabilize with a deficit in performance.…”

“…Amblyopia is the most common cause of monocular visual impairment in children and young and middle-aged adults. 1 , 2 In addition to decreased best-corrected visual acuity (VA) in the amblyopic eye, impaired accommodative performance has been widely noted in the literature, including reduced near point of accommodation, 3 – 5 decreased slope of the stimulus-response function, 6 – 10 and large steady-state error. 7 , 8 In a previous cross-sectional study, 11 we evaluated the accommodative accuracy of children with unilateral amblyopia aged 3 to 9 years using modified Nott retinoscopy.…”

Resolution of anisometropic amblyopia in a 48‐year‐old with refractive correction alone

“…The residual deficit in near visual acuity in the amblyopic eye may be because the patient did not wear optimal near correction during optical treatment. In addition, accommodation may be inaccurate when viewing monocularly with the amblyopic eye, affecting near visual acuity . Detailed accommodative tests were not performed in this case but may be of interest in future studies.…”

“…In addition, accommodation may be inaccurate when viewing monocularly with the amblyopic eye, affecting near visual acuity. 9 Detailed accommodative tests were not performed in this case but may be of interest in future studies.…”

Estado acomodativo en pacientes ambliopes y no ambliopes de 5 a 12 años de edad

“…El estado acomodativo se define a partir de tres funciones, las cuales deben evaluarse integralmente con el objetivo de establecer el diagnóstico del paciente; estas son la amplitud, la flexibilidad y el lag de acomodación. Las investigaciones acerca de las funciones acomodativas han comparado varios métodos, grupos etarios y pacientes con diferentes defectos refractivos en condiciones visuales óptimas; sin embargo, muy pocos estudios han tenido en cuenta la población infantil diagnosticada con ambliopía, y los resultados encontrados han confirmado que estos individuos difieren en el rendimiento acomodativo con respecto a los pacientes no ambliopes (1)(2)(3)(4)(5).…”