• Journal of Korean Ophthalmic Optics Society
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• v.14 no.3
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• pp.37-42
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• 2009

Purpose: There is uncertainty if the vergence facility would provide clinically significant supplementary information to the fusional vergence measurements. The purpose of this study was to determine the relationship between vergence facility and fusional vergence in a group of symptomatic subjects. Methods: A total of 114 symptomatic subjects aged 9 to 13 years, who passed the vision screening test, participated in this study. Vergence facility was measured with 8$\Delta$ BI/8$\Delta$ BO flipper lenses and a suppression control target, the 20/30 letter line on Vectogram 9 (Bernell, USA). Near fusional vergence was measured with a single 20/30 vertical line target by Von Graefe technique. In order to avoid excessive convergence stimulation, negative fusional vergence (NFV) range (blur, break and recovery) was measured followed by positive fusional vergence (PFV) ranges (blur, break and recovery). Results: Pearson correlations were calculated and showed no correlations between vergence facility and any of fusional vergence measurements (p>0.05). Also, there were no significant differences of vergence facility measurements on the compensating vergence that passed or failed Sheard and Morgan's criterion for comfortable vision (p>0.05). Conclusions: There was no correlation between vergence facility and fusional vergence among symptomatic subjects. Hence, both vergence facility and fusional vergence should be assessed for those with binocular dysfunction in order to make an accurate diagnosis and management plan.

• 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.20 no.2
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• pp.195-200
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• 2015

Purpose: This study was performed in order to figure out the influence of illumination on visual function. Methods: 40 adults (male 21, female 19) of average age $23.93{\pm}1.59$ years were participated in this study. The test chart surface illumination was adjusted to 5, 50, 200, 500 and 800 lx, and then amplitude of accommodation, near point of convergence, far and near distance phoria, far and near distance fusional vergence, relative accommodation, and accommodation lag were measured at each illumination condition. Results: As illumination intensity of test chart was reduced, amplitude of accommodation was significantly decreased (p<0.05), accommodation lag was also decreased, near point of convergence was receded, and horizontal phoria showed a tendency of esodeviation. In the case of negative fusional vergence, with reduction of illumination intensity, the break point and the recovery point were decreased but in the case of positive fusional vergence, the break point was increased. The negative and positive relative accommodation were significantly decreased (p<0.05) with reduction of illumination intensity. Conclusions: In clinical practice, visual functional test should be performed under condition of adequate illumination level through patient's living environment and job.

• Journal of Korean Ophthalmic Optics Society
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• v.12 no.4
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• pp.101-106
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• 2007

This study was performed to investigate whether vision therapy (vision training) was an effective way to influence fusional vergence and asthenopic symptoms in case of convergence excess. Patients who had esophoria at far and near had history and symptoms (horizontal diplopia, eye strain, asthenopia and blur). Among them for one chosen patient who had convergence excess, vision therapy and added plus lens were prescribed and trained for 7 weeks. 7 weeks later vision therapy was quite effective, that is, it was an effective means of reducing symptoms, improving fusional vergence and decompensating esophoria in patient with convergence excess. Therefore continuous research of vision therapy in binocular dysfunction was necessary.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.1
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• pp.37-43
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• 2013

Purpose: The present study was conducted to investigate whether the directions of eye movement in playing computer games for certain period affected the change of near point of convergence (NPC) and fusional reserve (FR) or not. Methods: Total 40 subjects in 20s who have the visual acuity of 1.0 or higher without any ocular disease and accommodative dysfunction were asked to successively play computer games. After the subjects were moving eyes in horizontal and vertical directions for 40 and 90 minutes, their horizontal fusional reserves, vertical fusional vergence and near point of convergence were measured. Results: The near point of convergence showed a tendency to be receded after computer gaming in the horizontal and vertical directions, and both of horizontal and vertical fusional reserves were significantly reduced. The range of declined fusional reserves and receded near point of convergence after computer gaming for 90 minutes was smaller than those after computer gaming for 40 minutes. The change of binocular vision was affected by the horizontal eye movement rather than the vertical movement when analyzed by the direction of eye movement. Conclusions: This study revealed that the change in FR and NPC was different along with dominant direction of eye movement during visual display terminal (VDT) tasks. Therefore, the adjustment of VDT working time is required to prevent the dysfunction of binocular vision according to the dominant direction of eye movement during VDT task.

• 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.

• Journal of Korean Ophthalmic Optics Society
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• v.17 no.2
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• pp.159-164
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• 2012

Purpose: Of the various methods of vision training, the essay aims to explore the effective ways of using the Fresnel prism lens in order to expand the positive fusional vergence for the patient having specific condition of convergence insufficiency or basic exophoria. Methods: 15 students of city of Daejeon university without an eye disease (average age $22.73{\pm}1.68$) were selected and underwent the subjective refraction test and binocular vision test, and recording their test results before vision training and replacing an identical frame with a lens of same quality after the full calibration, the lens was then adhered with the Fresnel prism lens and continued to train for thirty minutes daily during two weeks. Afterwards, the binocular vision test was reattempted. The observation of the change in the results of the binocular vision test in use of the fresnel prism lens in the vision training test was researched. Results: After training, the positive fusional vergence had increased to a number of $22.27{\pm}2.26$ $\Delta$, to 7.80 $\Delta$, at near, the fused cross cylinder test increased to an average of $0.55{\pm}0.09$ D, 0.40 D after training, showing a normal result. The value of negative relative accommodation after training had an average of $2.22{\pm}0.08$D, showing that 0.42 D had increased. The value of near point of convergence after training had an average of $6.13{\pm}0.53$ cm, showing that 2.80 cm had decreased. To patients who had convergence insufficiency or basic exophoria, the value of the near vision test that used the Fresnel prism lens which was able to expand BO positive fusional vergence had increased without phoria. Conclusions: The changes were tested and the effectiveness of the Fresnel prism lens, due to the nature of the lens itself, helped with both cosmetic effects and cost. It also allows good optical correction effects, in addition to these clinical effects indicated before. Therefore, it may be determined that the Fresnel prism lens binocular vision therapy for patients is more popular and highly recommended.

• 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.21 no.3
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• pp.235-242
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• 2016

Purpose: This study was to investigate whether the application of different diagnostic criteria affected the frequency of convergence insufficiency (CI). Methods: Eighty one subjects with mean age of 22.54 years (20 to 27 years) were evaluated. Binocularity tests after refraction were performed as the following tests: near point of convergence (NPC) with an accommodative target, phoria using von Graefe method, positive fusional vergence (PFV) with a phoropter. Subjects with CI were diagnosed when exophoria (exo) was greater at near than at distance ($exo{\geq}4{\Delta}$, or >$6{\Delta}$), fusional vergence was $PFV{\leq}11{\Delta}$ for blur, $PFV{\leq}15{\Delta}$ for break, Sheard's or Percival's criterion, and NPC was $NPC{\geq}6cm$, ${\geq}7.5cm$ or >10 cm. Results: Frequency of CI with one diagnostic criterion was ranged from 6.2% to 77.8%, and was overestimated or underestimated according to criteria. It was reduced to the range of 6.2% to 43.2% with diagnostic criteria more than two, especially to the range of 24.7% to 28.4% with lower variability in diagnostic criteria including phoria and Sheard's criterion. There were high relationship between total score of signs and phoria score (r = 0.772, p<0.001), and measured phoria and Sheard's criterion (r = -0.654, p<0.001), but NPC had a high variability and a weak or no significant relationship with other diagnostic criteria. Results suggested $exo{\geq}4{\Delta}$, Sheard's criterion and $NPC{\geq}7.5cm$ for diagnostic criteria of signs and sequence for CI. Conclusions: Frequency of CI is likely to be over- and underestimated with diagnostic criteria. Cutoff values and procedures for phoria, Sheard's criterion and NPC as clinical signs should be suggested definitely in diagnosis associated with CI.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.2
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• pp.137-142
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• 2013

Purpose: This study was designed to investigate the current status of visual acuity for elementary school students in Muan-gun and to analyze improvements of their visual function after vision training for the elementary school students who have either insufficiency of accommodation or vergence. Methods: Subjective refraction, objective refraction and binocular function were examined for 335 elementary school children from year 1 to year 6 live in Muan area, and then 47 students who have symptoms of binocular dysfunction among them were selected. We analyzed and compared between before and after vision training (VT) in binocular vision function results. Results: The results show that most of the subjects had much problem in near point convergence (NPC) than accommodation. After the vision training, the average of subjects NPC was improved about 5.93 cm, from $11.57 {\pm}1.850$ cm for before VT to $5.66{\pm}0.965$ cm for after VT. After VT positive fusional vergence at near distance after VT was $19.64{\pm}3.66$ $\Delta$, which was as much as double of near phoria. Accommodative amplitude was improved from $10.02{\pm}2.566$ D for before VT to $12.30{\pm}1.397$ D for after VT, which similar to mean of expected accommodative amplitude of 11.27 years old. Conclusions: Among insufficiency of accommodation and vergence NPC was improved specially, and accommodative facility and other ocular functions were also improved. Therefore, it is considered the vision training is very effective to recover from visual function problems.