• Journal of Korean Ophthalmic Optics Society
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• v.10 no.3
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• pp.159-164
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• 2005

Accommodation and convergence is combination movement which is closely connected with each other. When one of them is stimulated, both of functions occur at the same time. Specially, the convergence by the accommodation's stimulation is called as accommodative convergence. That has excess or deficiency according to refraction state of eye. This study was performed by using both of Gradient method and Heterophoria method to 41 adults who have no any ophthalmic disease. 1. As the result of investigation about the distribution of heterophoria at distance, there were orthophoria of 5 subjects, exophoria of 32 and esophoria of 4. Exoporia occupied at the hightest rate. The distribution of heterophoria at near cover a wider range more than at distance. 2. When we measured the horizontal heterophoria amount in the state of relaxation of accommodation power of lens, exophoria amount increased in case of 38 subjects. 3. The person who has $4{\sim}6{\Delta}/D$ which conform to normal AC/A ratio occupied 27 subjects(66%) in Heterophoria method and 16(39%) in Gradient method, respectively.

• Journal of Korean Ophthalmic Optics Society
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• v.9 no.2
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• pp.223-231
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• 2004

In most previous studies, the assessment of accommodative convergence to accommodative stimulus (AC/A) ratio was commonly made by measuring gradient AC/A ratio. This study deals with the proximal convergence/accommodation(PC/A)ratio measured by comparing values of the gradient AC/A ratio and the calculated AC/A ratio to prevail the clinical use of the AC/A ratio. Visual acuities of All 124 subjects had been corrected to at least 1.0 with either eye through their habitual refractive correction and the MEM dynamic retinoscopy was performed to estimate their accommodative response. And then the PC/A ratio was calculated by making use of the calculated AC/A ratio and the gradient AC/A ratio. This study showed that the difference between the mean calculated AC/A ratio and the mean gradient AC/A ratio in subgroups may be attributable to proximal convergence. Consequently, further studies on proximity cues including the PC/A ratio could be helpful to prevail the clinical use of the AC/A ratio.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.2
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• pp.219-228
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• 2015

Purpose: The current study was performed to compare the difference in binocular visual function depending on variable background colors at near work. Method: Fifty four adults (18 males, 34 females) who consented to the present study and had no ocular disease, ocular surgery history, strabismus and amblyopia with normal binocular vision were participated into this study. The subjects were asked to read the novels with black letter printed on white, red, green and blue background for 15 min. Then, their heterophoria, AC/A ratio, near point of convergence, accommodation facility, relative accommodation and vergence were measured before and after reading. The difference of measurements were compared. Result: Overall heterophoria was tended to decrease with regardless of background color. AC/A ratio showed a tendency of increase after reading the novels with all backgrounds except white background. Near point of convergence was significantly increased compared to before reading at all background color. Accommodative facility of dominant and non-dominant eyes were also significantly increased after reading however, binocular accommodative facility showed a tendency of decrease. Negative relative accommodation also decreased at all background colors however, the change of positive relative accommodation was not significantly different. In case of vergence, there was significant difference in break point of far BO and recovery point of far BI by the wavelength of background color. Conclusions: From the results, it was known there is convergence change depending on the wavelength of light even though same amount of accommodation and convergence is required when doing near work for certain period. Thus, it can be suggested that the adjustment of the near working environment which perception of various color was required, should be conducted according to the main wavelength.

• Journal of Korean Ophthalmic Optics Society
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• v.12 no.3
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• pp.125-130
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• 2007

The aim of this work was to study the relationship between subjective symptoms and binocular function during near work in forty one(12-17yr) schoolchildren. CISS symptom survey, amplitude of accommodation, accommodative facility, neagative relative accommodation(NRA)/positive relative accommodation(PRA) near point of convergence(NPC), heterophoria, AC/A ratios were measured. The results of measurement were compared with normal expected value of each test and classified into normal and abnormal group. Accommodative insufficiency was more general than convergence insufficiency and esophoria was greater than exophoria. NRA/PRA showed very high and AC/A ratios were very low compare with normal expected value. The results of CISS was as follows; most frequent symptom was tired, mean score was $16.63{\pm}7.49$, mean number of symptoms were $10.07{\pm}3.04$, and mean number of serious symptoms were $1.98{\pm}2.13$. After classified into 4 groups according to score of symptoms, number of symptoms, and degree of symptoms and then analyze the correlation compare with binocular vision test results. NRA was most correlated with group comparison, accommodative facility was most correlated with score of symptoms, NRA was most correlated with number of symptoms, and near horizontal phorias were most correlated with serious symptoms. NRA showed most correlative relation with near symptoms.

• Journal of Korean Ophthalmic Optics Society
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• v.17 no.2
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• pp.153-158
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• 2012

Purpose: The purpose of this study was to evaluate the convergence accommodation to convergence (CA/C) ratio and to investigate relationships among age, accommodative amplitude and PD (interpupillary distance) of adults in their early twenties with normal binocular vision. Methods: 44 subjects (mean age, $21.75{\pm}1.16$ years) with healthy eyes were examined. The CA/C ratios were measured by using the difference of Gaussian (DOG) target with retinoscopy. Results: The mean CA/C ratio was $0.052{\pm}0.017$ D/$\Delta$. A moderate negative correction was present between CA/C ratio and age (r = -0.50, p = 0.0005), and a highly positive correction was found between CA/C ratio and accommodative amplitude (r = 0.79, p<0.0001). There was no relation between PD and CA/C ratio. Conclusions: The CA/C ratio presented was mean value for adults in their early twenties with healthy eye between 19 and 25 years of age. There was a high correlation between accommodative amplitude and CA/C ratio. Therefore, the CA/C ratio will be useful basic information for comparison in age, gender and binocular anomalies with similar data from other countries.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.3
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• pp.319-324
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• 2015

Purpose: This study was designed to evaluate the changes of phoria and calculated AC/A ratio, and their recovery time points by watching 3D television (3D TV). Methods: 50 subjects (male 30, female 20) of 20s to 40s ages who can watch 3D, were measured phoria using a Howell phoria card at 3 m for distance and 40 cm for near. The phoria was evaluated before watching 3D TV and every 10 minutes from starting of watching 3D TV for 30 minutes, and every 5 minutes after finishing of watching 3D TV for 30 minutes again. Results: For the distance phoria during and after watching 3D TV, it was increased to more exophoria $-0.98{\pm}1.37{\Delta}$ (prism diopters) after 10 minutes from starting of 3D TV watching (p=0.063) and increased to more exophoria $-1.00{\pm}1.28{\Delta}$ after 30 minutes (p=0.024), and started to decrease after finishing of watching 3D TV and recovered to the level of before 3D TV watching ($-0.78{\pm}1.11{\Delta}$) after 20 minutes (p=0.32) with comparing to phoria of before watching 3D TV ($-0.80{\pm}1.12{\Delta}$). For the near phoria, it was also increased to more exophoria $-5.71{\pm}4.45{\Delta}$ after 10 minutes from starting of watching 3D TV (p=0.000) and $-6.58{\pm}4.36{\Delta}$ after 30 minutes (p=0.000), and started to decrease after finishing of watching 3D TV and recovered to the level of before watching 3D TV after 20 minutes ($-4.34{\pm}3.67{\Delta}$) (p=0.32) with comparing to the phoria of before watching 3D TV ($-4.36{\pm}3.66{\Delta}$). AC/A ratio was decreased from $4.92{\pm}1.17{\Delta}/D$ for before 3D TV watching to $4.11{\pm}1.50{\Delta}/D$ for after 30 minutes from starting of watching 3D TV (p=0.000), and increased after the end of watching 3D TV and recovered to the level of before 3D TV watching ($4.93{\pm}1.18{\Delta}/D$) after 25 minutes (p=0.598). Conclusions: During watching 3D TV at near, it showed a tendency of convergence insufficiency by decrease of calculated AC/A ratio as result that exophoria at near was higher increased than exophoria at distance. However, the increased exophoria at both near and distance was recovered to the level of base line after 25 minutes from the end of watching 3D TV. Through this study, it seems to need rational proposals of advice for watching 3D TV.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.2
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• pp.127-135
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• 2016

Purpose: The present study was aimed to investigate the effect of excessive near work by using a smartphone on subjective symptoms and accommodative and convergent function in their 40s. Methods: A total of 40 subjects(male, 10; female, 30; age, $43{\pm}7.2year$) in their 40s who have monocular and binocular visual acuities of 0.8 and 1.0, respectively, were divided into presbyopia group and non-presbyopia group. The subjects were asked to watch a movie on the screen of smartphone for 30 minutes. Their accommodative amplitude and facility, and relative accommodation were measured and compared before and after the use of smartphone. Changes in fusional vergence and near heterophoria by using smartphone were also evaluated. Furthermore, the change of subjective symptoms was surveyed using a questionnaire. Results: The presbyopia in mid-40s reported discomfort in an order of asthenopia, blur and dryness after the use of smartphone. Accommodative function and non-strabismic binocular function were generally decreased. Accommodative functions such as monocular accommodative amplitude, and relative accommodation were significantly decreased after smartphone use, and the change of phoria was observed as a result of decreased convergence and divergence. Negative fusional vergence was also significantly reduced. On the other hand, non-presbyopia in mid-40s reported discomfort in an order of asthenopia, dryness and blur, and only accommodative amplitude among the accommodative functions was significantly reduced. Significant reduction of negative fusional vergence was also observed. Conclusion: From the results, it was confirmed that the subjective discomfort of mid-40s after smarphone use might be related to whether presbyopia or not. It was due to not only the reduction of accommodative function but also the overall deterioration of visual function including heterophoria and fusional vergence. Therefore, it suggests that the accurate determination of the cause based on the overall visual functional tests such as heterophoria, fusional vergence as well as the decrease of accommodation due to the aging may be necessary when the mid-40s feels discomfortable symptoms by near work.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.4
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• pp.127-134
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• 2008

Purpose: The purpose of this study was to determine the expected values of accommodation and vergence system for analysis of binocular vision. Methods: Seventy three healty subjects without past history of eye disease were selected for this study, Patients showing clinical binocular anomalies including manifest squint and intermittent heterotropia were excluded and data was collected on 54 patients(mean age, 25.3${\pm}$2.7 year). Near point of convergence, distance and near phoiras were measured based on objective deviation angle. And then AC/ A ratio, relative accommodation were measured and all of the data were compared with the Morgan's expected values. Results: The values of distance and near heterophoria were 1.24${\pm}$2.72${\Delta}$ and 2.70${\pm}$4.91${\Delta}$ respectively and the gradient AC/A ratio was 3.92${\pm}$2.17${\Delta}$/D which were all about the same compared with the Morgan's expected values. The values of distance negative fusional convergence was same, however, distance positive fusional convergence was 7${\Delta}$ greater than the Morgan's one. There were no significant differences in the range values of both near vergences while the range of distance vergence was relatively larger than the Morgan's one. Positive relative accommodation was +0.37D greater and negative relative accommodation was -0.63D greater than the Morgan's values. Conclusions: The findings in this study appear that the Morgan's expected values have a possibilities of including considerable proximal convergence value. In comparison with Morgan's values, Korean's normal expected values have much different values of especially BO limit, so if the Morgan's values are directly applied to binocular vision analysis for Korean people, it may lead to an inaccurate binocular vision diagnosis. This results can be used to diagnose the accommodation and vergence system of Korean normal young adults.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.2
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• pp.255-261
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• 2015

Purpose: purchasing status and understanding trends of Functional progressive addtions lenses buyers', Correlation analysis of the Binocular Function value to determine ADD then can be apply sales and prescriptions. Methods: Years 2011 to 2014, 298 patients who were prescribed functional progressive lenses were analysed based on the prescription data and SPSS (Ver. 20.0) was treated using the statistics. Results: Results: The average age of our customers are $27.66{\pm}11.55$ years, average addition power is $+0.73{\pm}0.36D$, customers are using take a prescription of ADD $+0.75{\pm}0.28D$ was the highest 44.33% to 132 people. Near point of convergence of 276 people (92.62%) was mostly less than 10 cm, and near point of accommodation of 134 people (44.97%) was also below 10 cm, within 11~15 cm were 122 people (40.94%). Most of people were within normal range in terms of Near point of convergence and near point of accommodation, near point of accommodation tend to be longer than Near point of convergence. As you can see this result shows most of customers need extra help in their near point of accommodation instead of they are leak at it. FCC (Fused cross cylinder) check Value and ADD (addition power) tests showed that the value of a strong correlation (p=0.00), NPC and NPA were also p=0.001, the correlation of the NPC and ADD is p=0.003, In addition, NPA and ADD also showed a significant correlations (p=0.005). Near Point of Accommodation, negative relative accommodation, and positive relative accommodation are all significantly correlated (p=0.00). The short distance-related variables of the ADD which are NPC, NPA, Age, also appeared to side correlate significantly with each other. Conclusion: Binocular function values of the subjects were highly correlated with each other so precise examination is required. when Age young people are working at short distance, low ADD values was prescribed for solving discomfort. So, in the case of early presbyopia, accommodative insufficiency, or people feel fatigue when they often working at near although their accommodation function is normal, when functional progressive lenses are prescribed, expectation of this should be exactly notified.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.2
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• pp.171-177
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• 2011

Purpose: The purpose of this study was to investigate the relationships between reading ability and binocular functions, based on self tests through surveys. The possibility of the reading ability tests used in this study as a tool on the determination about vision efficiency was also evaluated. Methods: Through reading ability tests about 138 university students, 72 students (52.2%) of them were first selected. Through self tests about dyslexia and light sensitivity, 38 students (52.7%) of the first selected students were secondly selected, whose extents are more than 3. Binocular tests were carried out about three groups (high, middle, low) of these secondly selected students. Tests about NPCs, distance and near phoria, amplitude of accommodation, fusional vergence, AC/A ratio, accommodative facility, and vergence facility were performed as binocular tests. Results: NPCs were closest to eyes at high groups. Fusional vergence, AC/A ratio, accommodative facility, and vergence facility of high group showed higher than other groups. The phoria at middle group showed higher than other groups. Conclusions: We found that reading ability and some of binocular functions were closely related. Therefore, vision training, associated with insufficiencies of binocular functions, is expected to improve reading ability.