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.
Purpose: The purpose of this study was to determine if monocular and binocular accommodative facility tests would be useful in diagnosing general binocular dysfunctions. Methods: 95 symptomatic children, who were selected from comprehensive vision tests, were classified into four groups (29 subjects with accommodative dysfunctions, 28 subjects with vergence dysfunctions, 25 subjects with combined accommodative and vergence dysfunctions, 13 subjects with normal binocular functions). Monocular and binocular accommodative facility was measured with ${\pm}$2.00 D flipper lenses. Results: Statistical analysis revealed that binocular accommodative facility measurement was significantly lower than monocular accommodative measurement in the vergence dysfunction group (p<0.01). However, there were no differences between monocular and binocular accommodative facility measurements in the group of accommodative or combined accommodative and vergence dysfunction (p>0.05). In addition, subjects with general binocular dysfunctions performed significantly poorer than subjects with normal binocular function on monocular and binocular accommodative facility (p<0.000). Conclusions: As a result of this study, monocular and binocular accommodative facility test, which could differentiate dysfunction from normal as well as between dysfunctions, indicated useful means for diagnosis of general binocular dysfunctions.
To Analysis of Correlation of Visual Function Findings, by assessing convergence and accommodation, 92 selected objects without any ocular diseases by apperatuses of visual chart(Shinnippon CT30) and phoropter(Shinnippon VT10) at a shan distance(40 cm) were tested upon MEM retinoscopy(Welch Allyn, USA), BELL retinoscopy(Welch Allyn, USA), binocular accommodative facility (${\pm}2.00$ D nipper, Bernell Co., USA), vergence facility(prism nipper, Bernell Co., USA). The results showed as follows. MEM retinoscopy(accommodative lag) showed the same result of a right eye and left eye. Bell retinoscopy(accommodative lag) showed higher correlations between right and left eye than MEM. The lower accommodative lag meant the higher accommodative facility. The binocular accommodative facility(polaroid) was higher than binocular accommodative facility(red-green). Correlations of accommodative facility between right and left eye were higher, and as the higher monocular accommodative facility also meant the higher binocular accommodative facility, monocular and binocular accommodative facilities were relative to vergence facility, These findings can be used as a clinical guide by curing patients' visual function.
To assess convergence and accommodation at a short distance, 92 selected subjects without any ocular diseases by apperatuses of visual chart(Shinnippon CT30) and phoropter(Shinnippon VT 10) at a short distance(40 cm) were tested upon MEM retinoscopy(Welch Allyn, USA). BELL retinoscopy(Welch Allyn, USA), binocular accommodative facility (${\pm}2.00$ D flipper. Bernell Co., USA), vergence facility(prism flipper, Bernell Co., USA). There were such test results as MEM retinoscopy(R/L)($+1.05{\pm}0.87/1.02{\pm}0.80$ D). BELL retinoscopy ($17.89{\pm}12.12/17.94{\pm}11.72cm$), binocular accommodative facility (R/G)($7.69{\pm}6.48cpm$). binocular accommodative facility(polaroid)($11.76{\pm}5.22cpm$), monocular accommodative facility(R/L) ($13.9{\pm}6.27/13.8{\pm}5.96cpm$), vergence facility($13.5{\pm}6.40cpm$).
Purpose: This study aimed to compare and assess changes of visual functions in viewing an anaglyph 3D image. Methods: Visual functions were examined before and after viewing a 2D image and an anaglyph 3D image with red-green glasses on seventy college students (mean age = 22.29${\pm}$2.19 years). Visual function tests were carried out for von Graefe phoria test, accommodative amplitude test by (-) lens addition, negative relative accommodation (NRA) and positive relative accommodation (PRA) test, negative relative convergence (NRC) and positive relative convergence (PRC) test, accommodative facility, and vergence facility test. Results: Assessment of the visual functions indicated that near exophoria and accommodative amplitude were reduced after viewing a 3D image, and although there were small changes in relation to these findings, NRC and PRC showed tendencies to increase and decrease at near, respectively. There were no significant changes with NRA and PRA, and accommodative and vergence facility were shown to have improved. Conclusions: Changes of visual functions were more in the 3D image than the 2D image, especially at near than distance. Particularly, the improvement of accommodative and vergence facility could be related to an effect of subsequent accommodation and vergence shift to have stereopsis in the 3D image. These results indicate that an anaglyph 3D image may, to some extent, be the effect of vision training such as anaglyphs.
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.
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.
Purpose: This study was to investigate visual performance and subjective satisfaction with multifocal soft contact lenses at near works in university students. Methods: In a cross-over study design, 26 students (6 male, 20 female) who did not have any ocular disorder with at least 20/20(1.0) binocular vision were fitted with singlevision lenses (SofLens$^{TM}59$, Bausch + Lomb Co. USA) or multifocal lenses (SofLens Multifocal, Bausch + Lomb Co. USA). After 2 weeks, visual performance assessments included visual acuity, stereoacuity and contrast sensitivity function at distance and near. Near point of accommodation, accommodative facility, near point of convergence, vergence facility and near range of clear vision at near were examined. Students' satisfaction and preference were measured using survey questionaries. Results: Subjects maintained at least 20/20 binocular vision with multifocal and single-vision lenses at distance and near. There was no difference between multifocal and single-vision lenses in stereoacuity, contrast sensitivity function and vergence facility at far and near. The near point of accommodation, accommodative facility, near point of convergence and the near range of clear vision with multifocal lenses were better than single-vision lenses. On the survey questionaries, subjects reported that they preferred and satisfied with multifocal lenses with near works, and single-vision lenses with distance works. Conclusions: The majority of university students preferred multifocal to single vision lenses because multifocal lenses provided better visual performance at near works. This study suggests that multifocal lens is helpful for young adult in prolonged near works.
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.
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.
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