Browse > Article
http://dx.doi.org/10.14479/jkoos.2015.20.3.333

Characteristics of Accommodative Lags Determined by Objective and Subjective Methods and Their Correlation  

Yu, Dong-Sik (Dept. of Optometry and Vision Science, Kyungwoon University)
Kwak, Ho-Weon (Dept. of Optometry and Vision Science, Kyungwoon University)
Roh, Byeong-Ho (Dept. of Optometry and Vision Science, Kyungwoon University)
Son, Jeong-Sik (Dept. of Optometry and Vision Science, Kyungwoon University)
Publication Information
Journal of Korean Ophthalmic Optics Society / v.20, no.3, 2015 , pp. 333-339 More about this Journal
Abstract
Purpose: The aim of this study was to evaluate clinical characteristics of subjective accommodative lags determined by fused cross-cylinder (subjective method), and an open-field autorefractor (objective method) under uncorrected and corrected conditions. Methods: Thirty three healthy subjects (26 males and 7 females aged $23.73{\pm}1.35$ years from 22 to 27 years) participated. Four methods were used to determine accommodative lag: (1) a subjective method with the fused cross-cylinder (FCC) under +2.00 D fogging lenses condition, (2) an objective method with the autorefractor under uncorrected condition (3) a corrected method (effective accommodative lag) using equations presented by Gwiazda et al. in objective methods, and (4) a corrected method using equations presented by Mutti et al. in objective methods. Results: The mean accommodative lags were 0.72 D for subjective method, 0.82 D for uncorrected objective method, 0.88 D for corrected method with Gwiazda's equations, and 0.78 D for corrected method with Mutti's equations. There were significant differences between the objective accommodative lags, but no significant differences between the objective and subjective accommodative lags. The effective accommodative lags showed significant correlations between phorias and refractive errors. The effective accommodative lag by Mutti's equations had a high correlation with uncorrected accommodative lags (r=0.99, p<0.001). Conclusions: The objective accommodative lag correlated with phorias and refractive errors. Especially, The effective accommodative lag using Mutti's equations may be considered for clinical availability and qualitative evaluation associated with symptoms.
Keywords
Accommodative lag; Accommodative response; Autorefractor; Objective; Subjective; Phoria; Refractive error;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Garca A, Cacho P. MEM and Nott dynamic retinoscopy in patients with disorders of vergence and accommodation. Ophthalmic Physiol Opt. 2002;22(3):214-220.   DOI
2 Scheiman M, Wick B. Clinical management of binocular vision, 2nd Ed. Philadelphia: Lippincott Williams and Wilkins, 2002;72-96, 455-456.
3 Correction of Myopia Evaluation Trial 2 Study Group for the Pediatric Eye Disease Investigator Group. Accommodative lag by autorefraction and two dynamic retinoscopy methods. Optom Vis Sci. 2009;86(3):233-243.   DOI
4 Seidemann A, Schaeffel F. An evaluation of the lag of accommodation using photorefraction. Vision Res. 2003; 43(4):419-430.   DOI
5 Rosenfield M, Portello JK, Blustein GH, Jang C. Comparison of clinical techniques to assess the near accommodative response. Optom Vis Sci. 1996;73(6):382-388.   DOI
6 Rabbetts RB. Bennett and Rabbetts' clinical visual optics, 4th Ed. Oxford: Butterworth-Heinemann, 2007;133-134.
7 Elliott DB. Clinical procedures in primary eye care, 3rd Ed. Edinburgh: Butterworth-Heinemann, 2007;111-112:194-195.
8 Rosenfield M, Desai R, Portello JK. Do progressing myopes show reduced accommodative responses. Optom Vis Sci. 2002;79(4):268-273.   DOI
9 Mutti DO, Mitchell GL, Hayes JR, Jones LA, Moeschberger ML, Cotter SA et al. Accommodative lag before and after the onset of myopia. Invest Ophthalmol Vis Sci. 2006;47(3):837-846.   DOI
10 Gwiazda J, Thorn F, Held R. Accommodation, accommodative convergence, and response AC/A ratios before and at the onset of myopia in children. Optom Vis Sci. 2005; 82(4):273-278.   DOI
11 Shim HS, Lee SW, Shim MS, Choi SM, Jang SJ. Accommodative response measurement using both eyes openview autorefractometer. J Korean Ophthalmic Opt Soc. 2005;10(4):323-328.
12 Shim HS, Shim MS, Joo SH. A Study of accommodative response on emmetropia. J Korean Ophthalmic Opt Soc. 2006;11(3):187-192.
13 Han KA, Hwang JH, Mah KC. Objective measurement of accommodative responses with open-field autorefractor. Korean J Vis Sci. 2009;11(1):35-44.
14 Benzoni JA, Collier JD, McHugh K, Rosenfield M, Portello JK. Does the dynamic cross cylinder test measure the accommodative response accurately. Optometry. 2009; 80(11): 630-634.   DOI
15 Gwiazda J, Thorn F, Bauer J, Held R. Myopic children show insufficient accommodative response to blur. Invest Ophthalmol Vis Sci. 1993;34(3):690-694.
16 He JC, Gwiazda J, Thorn F, Held R, Vera-Diaz FA. The association of wavefront aberration and accommodative lag in myopes. Vision Res. 2005;45(3):285-290.   DOI
17 Mutti DO, Jones LA, Moeschberger ML, Zadnik K. AC/ A ratio, age, and refractive error in children. Invest Ophthalmol Vis Sci. 2000;41(9):2469-2478.
18 Erdfelder E, Faul F, Buchner A. GPower: a general power analysis program. Behav Res Methods Instr Comp. 1996; 28(1):1-11.   DOI
19 Yeo AC, Kang KK, Tang W. Accommodative stimulus response curve of emmetropes and myopes. Ann Acad Med Singapore. 2006;35(12):868-874.
20 Chat SW, Edwards MH. Clinical evaluation of the Shin- Nippon SRW-5000 autorefractor in children. Ophthal Physiol Opt. 2001;21(2):87-100.   DOI
21 Benjamin WJ. Borish's refraction, 2nd Ed. St. Louis: Butterworth Heinemann Elsevier. 2006;968-972.
22 Duane A. A new classification of the motor anomalies of the eye based upon physiological principles, together with their symptoms, diagnosis, and treatment. Ann Ophthalmol Otol. 1896;5:969-1008.
23 Cooper JS, Burns CR, Cotter SA, Daum KM, Griffin JR, Scheiman MM. Optometric clinical practice guideline: care of the patient with accommodative and vergence dysfunction. St. Louis: American Optometric Association, 2011;1-9.
24 Hofstetter HW. Useful age-amplitude formula. Optom World. 1950;38:42-45.
25 Locke LC, Somers W. A comparison study of dynamic retinoscopy techniques. Optom Vis Sci. 1989;66(8):540-544.   DOI
26 Bae HJ, Yoon MO, Kim HS, Eom JH. The correlation of refractive error and accommodative response. Korean J Vis Sci. 2010;12(2):103-109.
27 Baarg SB, Jeong YH. The accommodative lag and refractive error in early adults. J Korean Ophthalmic Opt Soc. 2012;17(1):59-65.
28 Allen PM, O'Leary DJ. Accommodation functions: codependency and relationship to refractive error. Vision Res. 2006;46(4):491-505.   DOI
29 Leon AA, Medrano SM, Rosenfield M. A comparison of the reliability of dynamic retinoscopy and subjective measurements of amplitude of accommodation. Ophthalmic Physiol Opt. 2012;32(2):133-141.   DOI
30 Wold JE, Hu A, Chen S, Glasser A. Subjective and objective measurement of human accommodative amplitude. Cataract Refract Surg. 2003;29(10):1878-1888.   DOI
31 Schor C. The influence of interactions between accommodation and convergence on the lag of accommodation. Ophthalmic Physiol Opt. 1999;19(2):134-150.   DOI