Objective and subjective assessment of accommodative insufficiency.
Optom Vis Sci
; 101(1): 44-54, 2024 Jan 01.
Article
em En
| MEDLINE
| ID: mdl-38350057
ABSTRACT
SIGNIFICANCE:
A variety of subjective and objective procedures are available to measure the amplitude of accommodation. However, it is unclear whether the standard criterion of Hofstetter's minimum minus 2 D can be used to diagnose accommodative insufficiency with each of these techniques.PURPOSE:
The use of objective dynamic retinoscopy and three subjective techniques to diagnosis accommodative insufficiency was examined.METHODS:
A total of 632 subjects between 8 and 19 years of age were enrolled. Accommodative lag, monocular accommodative facility, and subjective (push-up, modified push-down, and minus lens) and objective (dynamic retinoscopy) amplitude of accommodation were quantified. Accommodative insufficiency was diagnosed based on Hofstetter's minimum minus 2 D for each subjective method, as well as adding an additional subjective criterion (either accommodative lag exceeding 0.75 D or monocular accommodative facility falling below the age-expected norms).RESULTS:
The prevalence of accommodative insufficiency was lowest and highest with the push-up (7.9 and 1%) and dynamic retinoscopy (94 and 12%) procedures when measured without and with the additional subjective criteria, respectively. Comparing the validity of dynamic retinoscopy against the traditional criterion, moderate to low sensitivity and high specificity were found. However, adding the additional subjective criteria improved the findings with moderate to high sensitivity and high specificity. Using a cutoff for dynamic retinoscopy of 7.50 D showed moderate diagnostic accuracy based on likelihood ratios.CONCLUSIONS:
It is clear that a revised definition of accommodative insufficiency is required, which must include the method of assessing accommodation. The various objective and subjective methods for quantifying the amplitude of accommodation are not interchangeable, and subjective assessment does not provide a valid measure of the accommodative response.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Presbiopia
/
Cristalino
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Optom Vis Sci
Assunto da revista:
OPTOMETRIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Colômbia
País de publicação:
Estados Unidos