• Journal of Korean Ophthalmic Optics Society
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• v.19 no.1
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• pp.79-85
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• 2014

Purpose: This study investigated accommodative changes by measuring accommodative response, appearing on the normal and convergence insufficiency Group, by using both eyes open-view auto-refractometer (Nvision-K5001, shin-nippon, Japan). Methods: It carried out objective and subjective refractions, targeting 74 college students (54 males and 20 females) aged between 19 and 29 ($21.59{\pm}2.53$), spherical equivalent OD $-2.28{\pm}2.03$ D, OS $-2.18{\pm}2.01$ D, by measuring accommodative responses at full correction and under correction with plus lens +0.25, +0.50, +0.75 arbitrarily added. Results: In the group of normal and convergence insufficiency, the shorter fixation distances were, the greater accommodative lags showed. The group of convergence insufficiency showed the lesser changes of accommodative response than those of normal. But we found that the convergence insufficiency group had a little larger accommodative amplitude in the total fixation distances. The full correction of convergence insufficiency group and the under correction (+0.50 D) of normal were alike in the accommodative responses. We have also investigated that the correlation between accommodative responses and fixation distances was decreased steeply at the excessive low vision correction. Conclusions: Under correction (+0.50 D) in a near distance is expected to avoid unnecessary accommodative responses, make eyes relaxed and comfortable.

• Journal of Korean Ophthalmic Optics Society
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• v.14 no.1
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• pp.109-114
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• 2009

Purpose: This study was designed to investigate the condition of refractive correction on wearing glasses currently of elementary school children and their accommodative ability in Jinju city. Methods: Objective refraction, subjective refraction, amplitude of accommodation, negative and positive accommodation, accommodative facility, and dynamic retinoscopy were examined on 60 elemenary school children who aged 8~12 wearing myopiacorrected glasses. Results: The condition of refractive corrections was distributed that a case of full correction was 11.7%, a case of low correction with more than 0.8 visual acuity (VA) was 10%, and a case of low correction with less than 0.8 VA was 78.3% in wearing glasses currently. In results from examination of accommodative ability, the number of children having accommodative anomaly is 8 persons (13.3%), they were divided into accommodation insufficiency (4 persons), accommodative facility insufficiency (2 persons), accommodation excess (1 person), and accommodation insufficiency related to ocular function (1 person). Conclusions: It is demanded a periodic inspection of refractive correction to growing children, and the refractive correction after due consideration to accommodative ability is really needed.

• Journal of Korean Ophthalmic Optics Society
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• v.12 no.2
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• pp.87-93
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• 2007

Eye examination was performed for diagnosis accommodative and binocular dysfunction. The prevalence rates were similar to other studies, therefore patients required not just the correction of the refractive error but a specific treatment for each diagnosed problems. Two symptomatic(diplopia, asthenopia, and intermittent blur) patients diagnosed as a convergence insufficiency was given full correction with visual training for 4weeks. They had a one or mixed binocular problems included accommodative insufficiency. Following 4 weeks later, visual training was effective to Improve convergence and suggest that continuous observation is necessary.

• 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.15 no.2
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• pp.169-174
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• 2010

Purpose: The purpose of this study is to evaluate the long-term stability of the improved symptoms and accommodative functions after completion of accommodative therapy. Methods: Seven children (mean age${\pm}$SD: $12{\pm}1.41$ years) who were successfully treated with a vision therapy program for either accommodative insufficiency or infacility were followed for 1 year. The visual symptoms of the subjects were measured by the College of Optometrists in Vision Development Quality of Life (COVD-QOL) checklist, and this was followed by measurement of the monocular and binocular accommodative facility with ${\pm}2.00$ D flipper lens. Results: The mean visual symptoms at the 1 year follow-up examination ($15.14{\pm}8.59$) showed a small increase, but there was no significant difference (p=0.446) from post-therapy ($11.86{\pm}7.22$). There was small regression in the monocular (left eye, $13.86{\pm}3.93cpm$) and binocular ($11.14{\pm}3.13cpm$) accommodative facility at the 1 year follow-up examination, but there were no significant different from the monocular ($15.86{\pm}4.14cpm$, p=0.147) and binocular ($13.21{\pm}3.76cpm$, p=0.066) accommodative facility measurements at post-therapy. Also, every subject met the normative values of ${\geq}7$ cpm for monocular accommodative facility and ${\geq}5$ cpm for binocular accommodative facility in the long-term. Conclusions: There was long-term maintenance of the improved visual symptoms and accommodative functions, and so it is clear that the positive therapeutic effects persist with accommodative therapy.

• Journal of Korean Ophthalmic Optics Society
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• v.15 no.3
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• pp.287-291
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• 2010

Purpose: The aim of this study was to compare binocular functions such as near point of convergence (NPC), AC/A ratios, heterophoria, accommodation, accommodation lag, positive relative accommodation (PRA), negative relative accommodation (NRA), positive relative convergence (PRC), negative relative convergence (NRC) in normal subjects and convergence insufficiency. Methods: 86 subject (male n=45, female n=41, mean $age{\pm}SD=23.27{\pm}2.85$ years) without amblyopia, strabismus, and ocular pathology were studied. Forty three patients each group were classified as normal subjects and convergence insufficiency group based on AC/A ratio and far and near phoria. Binocular function of the two groups was measured using phoropter. r. Results: The values between normal subjects and convergence insufficiency were 5.71 cm and 7.07 cm for NPC, 5.28 and 2.81 for Heterophria AC/A, 0.92 exo/3.36 exo and 2.17 exo/10.84 exo for far and near phoria, 15.49/23.30/13.30 and 13.50/20.02/9.09 for PRC, respectively. However, there were no significant differences between normal subjects and convergence insufficiency for accommodative amplitude, accommodative lag, PRA, NRA, BI vergence test, BO vergence test, NRC. Conclusions: Both groups were a significant difference for cover test, NPC, Heterophria AC/A, far and near phoria, break point of PRC, and recovery point of PRC.

• Journal of Korean Ophthalmic Optics Society
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• v.17 no.3
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• pp.279-284
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• 2012

Purpose: We measured the amplitude of accommodation using the push-up and push-away tests and near point of convergence (NPC) and investigated the accommodative insufficiency (AI) and convergence insufficiency (CI) in elementary school children of 12~13 years old. Methods: 88 students who aged 12~13 $12.63{\pm}0.51$ years old with more than 1.0 spectacle best corrected visual acuity were examined using push-up and push-away tests. The break and recovery points of NPC also were measured. Results: Mean amplitudes of accommodations using push-up and push-away tests were $11.52{\pm}2.50D$ and $10.06{\pm}1.97D$, respectively in right eye (P<0.001). Mean break and recovery points in NPC were $8.66{\pm}1.99cm$ and $10.98{\pm}2.06cm$. AI and CI showed 28.75% and 30.00% each. 48.75% was within normal range in both amplitudes of accommodations according to their age expected and convergence. Students having both AI and CI were 7.50%. Conclusions: A high correlation between the push-up test and push-away test was found in elementary school children (r=0.6025; P<0.05). Students having normal amplitude of accommodation by their age expected and normal convergence were 71.25% and 70.00%, respectively.

• 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.

• Journal of Korean Ophthalmic Optics Society
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• v.10 no.3
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• pp.205-213
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• 2005

To evaluate the reliability of binocular vision measurements by phorometry. 90 students volunteered to participate in this study. 25 subjects were males, and 65 were females, they ranged in ages from 21 to 30 years. All subjects had normal ocular and systematic health, and all of them had at least 1.0 visual acuity with their best correction. At negative relative convergence(NRC) measurement in distance, the percentage of subjects is included in expected value(blur point/break point/recovery point) was 78%/61%/67%, divergence excess(DE) was 9%/31%/33%, and divergence insufficience(DI) was 13%/8%/9%, respectively. And positive relative convergence(PRC) measurement, includes expected value was 20%/46%/39%, convergence excess(CE) was 22%/14%/16%, and convergence insufficience(CI) was 35%/40%/45%. AC/A ratios of 42 subjects were normal. 38 were low, and the rest of them high. A low AC/A ratio is usually the result of a small vergence response in relation to accommodation. Negative relative convergence(NRC) at near, includes expected value was 26%/29%/44%, divergence excess(DE) was 61%/33%/24%, and divergence insufficience(DI) was 3%/38%/32%. And PRC at near, includes expected value was 33%/40%/31%, convergence excess(CE) was 61%/23%/42%, and convergence insufficience(CI) was 6%/37%/27%. For the near point of convergence(NPC) test, 58% of their subjects had a break of ${\leq}8cm$ with the accommodative target. In case of NRA(PRA) measurement, the expected value was 41%(33%). Accommodative insufficiency (AI) was 33%(43%), and accommodative excess(AE) was 26%(24%), respectively. AE was related to respectively low values of NRA. AI and CE are associated with high value of NRA, and the dysfunction of convergence excess combined with AE was related to a normal-high values of NRA. PRA in AI was related to a low value, wheres the dysfunction are associated with high values of PRA.

• Journal of Korean Ophthalmic Optics Society
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• v.17 no.3
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• pp.273-278
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• 2012

Purpose: Average of the maximum accommodation amplitude of myopia in different generation, early 20's and early 40's were compared according to gender, degree of myopia. Methods: Maximum amplitude of accommodation for each 100 patients of early 20's and 40's were measured with push-up method. Maximum amplitude of accommodation expectations based on Hofstetter formula were classified into three groups of under, normal and excess. Results: The average of amplitude of accommodation was 9.77~11.64 D $(10.77{\pm}2.49D)$ in early 20's and 4.67~6.21 D $(5.34{\pm}1.28D)$ in early 40's. In early 20's, minimum expectations of amplitude of accommodation for under, normal and excess groups were 20%, 75%, and 5%, repectively. In early 40's, excess and under groups were 5% and 18%, repectively, but there was no excess group. Conclusions: According to increasing age, amplitude of accommodation of both age groups showed decreased, and no significant difference was found in degree of myopia with gender. Difference between mean of expected accommodation amplitude and maximum of accommodation amplitude was compared, and it was found that maximum of accommodation amplitude of 20's was smaller than mean of expected accommodation. From the result, it was expected that people in early 20's who have more working times might have festinated accommodative insufficiency than 40's.