Binocular Adaptation to +2 D Lenses in Myopic and Emmetropic Children

Sreenivasan, Vidhyapriya; Irving, Elizabeth L.; Bobier, William R.

doi:10.1097/opx.0b013e3181a59d78

Cited by 22 publications

(24 citation statements)

References 59 publications

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“…In emmetropic adults, emmetropic children, and myopic children, monocular conditions either resulted in no significant change in accommodative lag or in a slight increase in accommodative lag of up to 0.25 D compared to binocular viewing conditions (Seidel, Gray, & Heron, 2005; Sreenivasan et al, 2008; Sreenivasan et al, 2009). Although the accommodative testing conditions in CLEERE may have slightly increased the amount of accommodative lag, this should only have enhanced our ability to detect a relationship between lag and the progression of myopia.…”

Section: Discussionmentioning

confidence: 90%

“…Previous research indicates that extended near work would, at most, slightly reduce the amount of accommodative lag, making it unlikely that temporal aspects of accommodative lag influenced the outcome of this study. Studies have reported either no change in accommodative lag after 30 minutes of reading in adults (Shapiro, Kelly, & Howland, 2005) or a slight decrease in accommodative lag of about 0.25 D after 20 minutes of watching cartoons in myopic children (Sreenivasan, Irving, & Bobier, 2009) and emmetropic adults (Sreenivasan, Irving, & Bobier, 2008). Similarly, more cognitively intense near activities would, at most, be expected to slightly reduce the amount of accommodative lag measured compared to the task of keeping letters clear used in the present study (Kruger, 1980; Winn, Gilmartin, Mortimer, & Edwards, 1991).…”

Section: Discussionmentioning

confidence: 99%

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Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction

et al. 2011

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The relationship between accommodative lag and annual myopia progression was investigated using linear models in 592 myopic children wearing a full refractive correction in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. The mean (± SD) age and spherical equivalent refractive error at baseline were 10.4 ± 1.8 years and −2.13 ± 1.24 D, respectively. The mean annual progression of myopia was −0.45 ± 0.32 D, and the mean accommodative lag (for a 4-D Badal stimulus) was 1.59 ± 0.63 D. Neither lag at the beginning nor at the end of a yearly progression interval was associated with annual myopia progression (all p ≥ 0.12). These data suggest that foveal hyperopic retinal blur during near viewing may not drive juvenile-onset myopia progression.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction

et al. 2011

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“…Previous studies have demonstrated reduced accommodative gains in infants and young children when viewing stimuli under monocular versus binocular conditions. 27 However, the increase in accommodative response from monocular to binocular viewing becomes quite small (approximately 0.25D) by school age 28, 29 into adulthood. 30 Given this evidence, it is possible that the lower accommodative amplitudes observed in the preschool aged subjects may be partially attributed to the monocular testing conditions.…”

Section: Discussionmentioning

confidence: 99%

Subjective versus Objective Accommodative Amplitude

Anderson¹,

Stuebing²

2014

Optometry and Vision Science

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Purpose This study compared subjective and objective accommodative amplitudes to characterize changes from preschool to presbyopia. Methods Monocular accommodative amplitude was measured with three techniques in random order (subjective push-up, objective minus lens stimulated, and objective proximal stimulated) on 236 subjects 3–64 years using a 1.5mm letter. Subjective push-up amplitudes were the dioptric distance at which the target first blurred along a near-point rod. Objective minus lens stimulated amplitudes were the greatest accommodative response obtained by Grand Seiko autorefraction as subjects viewed the stimulus at 33cm through increasing minus lens powers. Objective proximal stimulated amplitudes were the greatest accommodative response obtained by Grand Seiko autorefraction as subjects viewed the stimulus at increasing proximity from 40cm up to 3.33cm. Results In comparison with subjective push-up amplitudes, objective amplitudes were lower at all ages, with the most dramatic difference occurring in the 3–5 year group (subjective push-up = 16.00 ± 4.98D versus objective proximal stimulated = 7.94 ± 2.37D and objective lens stimulated = 6.20 ± 1.99D). Objective proximal and lens stimulated amplitudes were largest in the 6–10 year group (8.81 ± 1.24D and 8.05 ± 1.82D, respectively) and gradually decreased until the fourth decade of life when a rapid decline to presbyopia occurred. There was a significant linear relationship between objective techniques (y = 0.74 + 0.96x, R2 = 0.85, p<0.001) with greater amplitudes measured for the proximal stimulated technique (mean difference = 0.55D). Conclusions Objective measurements of accommodation demonstrate that accommodative amplitude is substantially less than that measured by the subjective push-up technique, particularly in young children. These findings have important clinical implications for the management of uncorrected hyperopia.

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“…37,38 At the same time, the near phoria was usually shifted in the exophoric direction and was out of the normal range. A recent report by Sreenivasan et al 45 studied the effect of binocular adaptation to +2 D near-additions on response AC/A ratios of myopic and emmetropic children. Based on their results, they suggested that the +2 D near-additions would reduce both lag of accommodation and esophoria, and therefore may be beneficial for myopic children with near esophoria.…”

Section: Discussionmentioning

confidence: 99%

Effect of customized near addition lenses on transient myopia induced by near-work

Nan¹,

Seger²,

Crandall³

et al. 2010

OPTO

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Purpose: To verify whether optimal near add power can reduce near-work induced transient myopia (NITM). Methods: Eighteen subjects including nine progressive myopes (PMs) and nine stable myopes (SMs) were involved in this study. We measured the accommodative error and the near phoria at 40 cm under fully corrected conditions for each subject. These findings were then used to determine optimal near-add power for each subject based on formulae derived from a previous study. Under both with and without near-add conditions, NITM was obtained by comparing the refractions immediately before and after performing continuous computer work at 40 cm for an hour. The refraction was determined by a COAS aberrometer. Results: Using customized near-addition lenses (C-ADD) we found significantly decreased retinal defocus from 0.49 ± 0.12 (SD) D to 0.08 ± 0.11 D. The near phoria showed a significant exophoric shift from -1.84 ± 1.95 prism diopter (pd) to -5.37 ± 1.63 pd, but was still in the normal range. We also found that the differences in NITM between the two groups and between the two conditions (ie, with and without C-ADD) were both significant. Further comparisons indicated that the NITM in the SM group was significantly reduced after using C-ADD; in the PM group the reduction of NITM was not significant. Conclusions:The results suggest that C-ADD balances the load of accommodation and vergence, significantly decreasing retinal blur during the near-work, and may be able to reduce the NITM.

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Binocular Adaptation to +2 D Lenses in Myopic and Emmetropic Children

Cited by 22 publications

References 59 publications

Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction

Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction

Subjective versus Objective Accommodative Amplitude

Effect of customized near addition lenses on transient myopia induced by near-work

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