• Journal of Korean Ophthalmic Optics Society
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• v.19 no.3
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• pp.345-351
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• 2014

Purpose: The accommodative response and the near horizontal phoria were examined with additional spherical power to analyze the stimulus and response AC/A ratios that suggest reference data for the binocular vision. Methods: The open-field autorefractometer (Nvision-K 5001, Shin nippon) and modified thorington method (MIM card; Muscle Imbalance Measure card, Bernell) at 40 cm were utilized to measure the accommodative response and the near horizontal phoria for 81 persons ($20.89{\pm}1.92$ years old) with additional spherical power. The stimulus and the response AC/A ratios were calculated by gradient AC/A method. Results: The exophoria group showed the highest accommodative response ($1.92{\pm}0.26D$) at 40 cm, followed by orthophoria group and esophoria group($1.72{\pm}0.26D$ and $1.62{\pm}0.42D$, respectively) Meanwhile, the esophoria group showed the biggest ocular deviation for the near ($23.24{\Delta}$) followed by the orthophoria group and exophoria group ($19.76{\Delta}$ and $15.14{\Delta}$, respectively). The biggest difference of the stimulus and the response AC/A ratios was $1.72{\Delta}$ for the exophoria group with -2.00 D, while the one was $3.43{\Delta}$ for the esophoria group with +1.00 D. There was a significant difference between AC/A ratios for the exophoria group with -2.00 D, -1.00 D and the esophoria group with +3.00 D, +2.00D, +1.00D and -1.00D. Conclusions: The difference between stimulus and response AC/A was greater when increased minus spherical power for the exophoria group, while it was greater when increased plus spherical power for the esophoria group. Furthermore, the difference for the esophoria group was a greater than the one for the exophoria group.

• Journal of Digital Convergence
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• v.14 no.10
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• pp.375-380
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• 2016

This study aimed to evaluate the possibility for assessment of binocular visual function about alteration for near point of convergence (NPC). Study subjects were total 30 (emmetropia 16, myopia 14), who had no eye disease except for the phoria and monocular corrected vision 1.0 and over. Near point of accommodation (NPA), NPC and phoria test were measured both at ordinary and stimulation of +1D. Ordinary NPC was 1.77cm shorter than NPC stimulated +1D and the NPC of emmetropia was shorter than that of myopia. The difference between NPC stimulated +1D and ordinary were increased in the emmetropia. As the NPC increased, the AC/A ratio was elevated and the feature of near exophoria appeared. The results suggested that the alteration of NPC might substitute AC/A ratio for reference variable of binocular vision. If converged and analyzed comparatively with another binocular visual evaluation test, the alteration of NPC could be developed for substitution of evaluation test.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.3
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• pp.341-347
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• 2015

Purpose : This study was to examine a correlation of response AC/A ratio by additional spherical powers with PD(Pupilary distance) and relative accommodation, and was to investigate correlation of CA/C ratio by prism powers. The mean differences between a reciprocal response AC/A ratio and a CA/C ratio were compared, and were suggested to be used as data in the refractive power and prism prescriptions in the clinical. Methods: The open field autorefractometer (Nvision-K 5001, Shin nippon) and Howell target at 40 cm fixation distance to 62 persons with average $22.62{\pm}2.84$ ages were used to measure the response AC/A ratio according to additional Spherical powers. The CA/C ratios were measured using the DOG card at 40cm according to prism powers. Results: When the response accommodation according to Additional Spherical power changes and the response accommodation according to prism power changes were compared, it was larger than the response accommodation according prism power change. These were significant differences statistically. The correlation of response AC/A ratio and PD is showed as r = -0.158, the CA / C ratio is shown as r = 0.093. The correlation of response AC/A ratio and relative accommodation showed as r = -0.253, the CA/C ratio showed as r = 0.566 that is predictable correlation. The correlation of response AC/A ratio and CA/C ratio showed as r = -0.355 that is low minus correlation (p = 0.000). The difference between a reciprocal response AC/A ratio and a CA/C ratio showed $0.12{\pm}0.06D/{\Delta}$ with a significant difference statistically (p=0.000). Conclusions: The correlation of relative accommodation and CA/C ratio showed that depend on the individual, The more a relative accommodation is, the higher a response accommodation of convergence by convergence stimulus is. The reciprocal response AC/A and CA/C ratio showed significant differences statistically. This can have higher CA/C ratio in patients with low AC/A ratio in clinical as an independent variable. Thus when the abnormal binocular vision was prescribed in the clinical, it is necessary to consider the accommodative response even if the AC/A ratio is a normal range.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.2
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• pp.117-123
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• 2013

Purpose: The aim of this study was to propose effective data for the clinical examinations of binocular vision by comparative analysis of measuring the near horizontal phoria according to accommodative stimulations. Methods: It carried out near horizontal phorias, targeting 104 college students (50 males and 54 females) aged between 19 and 24 ($20.27{\pm}1.31$). It made a comparative analysis of changes in near horizontal phoria according to accommodative stimulations by using the von Graefe, Maddox rod and the Howell phoria methods respectively. We have also investigated the AC/A ratio in all phoria groups. Results: As the additional lenses were changed to the negative (-) diopter, the near horizontal phoria changed to the esodeviation. At this time, the rate of change in the section signifies the AC/A ratio, and the values were not consistent based on the evaluating methods or on each section. The AC/A ratio of the esophoria group appeared the largest value in all groups. As a result of analyzing AC/A ratio at the exophoria group using the von Graefe method, the AC/A ratio was $1.568{\pm}1.937$ ${\Delta}/D$ on the additional lenses +2.00 D and $2.527{\pm}2.253$ ${\Delta}/D$ on the additional lenses -1.00 D and at the esophoria group using the Howell phoria method, the AC/A ratio was $5.521{\pm}1.337$ ${\Delta}/D$, $5.593{\pm}1.623$ ${\Delta}/D$ on the additional lenses +2.00 D, +1.00 D and $4.687{\pm}1.643$ ${\Delta}/D$ on the additional lenses -2.00 D. These were significant differences statistically. Conclusions: In the exophoria group, when the (-) lenses were added, the averages of the AC/A ratio were shown to be high but in the esophoria group, when the (+) lenses were added, the of AC/A ratio was high.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.4
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• pp.417-423
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• 2011

Purpose: This study was to investigate that near gradient AC/A ratio could be used to prescribe a patient with distance exophoria, we compared the difference between distance gradient AC/A ratio and near gradient AC/A ratio. Also, this thesis was to understand the relationship between calculated AC/A ratio and gradient AC/A ratio. Methods: Objective and subjective refractive error were corrected and we used Howell (3 m) chart for distance phoria tests and Howell-Kim (40 cm) chart for near phoria tests. The near gradient AC/A ratio and calculated AC/A ratio were used by Howell-Kim (40 cm) combined with +1.00 D, -1.00 D, +2.00 D and -2.00 D. Results: The average value of distance exophoria was 1.17${\pm}$1.17 $\Delta$, and the average value of near exophoria was 3.71${\pm}$2.80 $\Delta$ (t-test. p<0.001). The correlation of distance phoria with near phoria was little higher (r = 0.59, p < 0.001). Gradient AC/A ratios depending on measuring distance and stimulus were higher (r = 0.11~0.53. P < 0.001), when distance was shorter and stimulus to accommodation was more. Also, stimulus to accommodation by plus lens was higher than stimulus to accommodation by minus lens (paired t-test. p < 0.001). There was negative correlation between calculated AC/A ratio and gradient AC/A ratio. As the calculated AC/A ratio was higher, gradient AC/A ratio was lesser. Near gradient AC/A ratio was slightly higher than distance gradient AC/A ratio. Distance and near gradient AC/A ratio taken through the subjective -1.00 D were 1.30 $\Delta$/D and 1.68 $\Delta$/D(t-test. t=1.67, p < 0.001). Conclusions: There is negative correlation between calculated AC/A ratio and gradient AC/A ratio. Also, there is subtle difference between near gradient AC/A ratio and distance gradient AC/A ratio. Therefore, we need to measure distance gradient AC/A ratio when a practitioner prescribe glasses for a patient with distance exophoria.