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C. Rook, D. Oystreck, S. E. Loudon, D. G. Hunter; Comparison of the Accommodative Response in Amblyopic and Non-Amblyopic Eyes. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4704.
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Accommodative dysfunction has previously been reported in amblyopic eyes. Most studies were performed in a non-clinical setting, using few subjects and no children. In this study, a prospective, case control design was used to assess the accommodative ability of amblyopic children.
Two clinical tests of accommodation were used to compare the amblyopic eye with the sound eye and in age matched controls: 1) WAM 5500 binocular accommodation autorefractor, and 2) dynamic retinoscopy. The accommodative response to a 3 diopter stimulus was assessed under binocular and monocular viewing conditions.
To date, 37 amblyopic and 24 control subjects (mean age 7.8 years) have been tested. Accommodative response was normal in 49% of amblyopic eyes, 70% of sound eyes, and 76% of non-amblyopic control eyes under binocular viewing conditions. Accommodative response was normal in 51% of amblyopic eyes, 62% of sound eyes, and 70% of non-amblyopic control eyes under monocular viewing conditions. Dynamic retinoscopy was normal in 84% of amblyopic eyes, 92% of sound eyes, and 100% of non-amblyopic control eyes.
When tested with an objective, quantitative method, amblyopic eyes appeared to have a reduced accommodative response under both binocular and monocular viewing conditions. Sound eyes in amblyopia patients performed as well as non-amblyopic eyes in controls. The reduced accommodative response in amblyopic eyes may have implications in the treatment of amblyopia as well as in amblyopia screening. Enrollment of more patients and controls will be needed to provide sufficient power for meaningful statistical analysis.
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