July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Comparison of the short-term effect after 6 weeks of treatment of accommodative infacility with either +0.5D addition in spectacles or accommodation exercises with Hard Chart
Author Affiliations & Notes
  • Martin Balke
    Optometry, Radiography and Lighting Design, University College of Southeast Norway, Kongsberg, Buskerud, Norway
  • Per O Lundmark
    Optometry, Radiography and Lighting Design, University College of Southeast Norway, Kongsberg, Buskerud, Norway
  • Footnotes
    Commercial Relationships   Martin Balke, None; Per Lundmark, None
  • Footnotes
    Support  Research scholarship fra C-optikk, Kongsberg, Norway
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2944. doi:
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      Martin Balke, Per O Lundmark; Comparison of the short-term effect after 6 weeks of treatment of accommodative infacility with either +0.5D addition in spectacles or accommodation exercises with Hard Chart. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2944.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Accommodative infacility (AI) is a common disorder in children. Conventional optometric management includes spectacles with a low plus addition (ADD) or vision therapy (VT). The purpose of this study was to compare the short-term effect of ADD with VT in children with newly diagnosed AI.

Methods : Children between 8 and 12 years of age who came for an optometric examination and were diagnosed with AI for the first time, were invited into the study. Recruited patients were systematically allocated to be treated with i) spectacles with distance correction and +0.5D addition or ii) a regimen of accommodation exercises using Hard Charts for a period of 6 weeks. Monocular accommodation facility for right and left eye (MAF-R, MAF-L) and binocular accommodation facility (BAF) was measured with +2/-2 flipper and registered in cycles per minute (cpm). Subjective symptoms were measured by means of the convergence insufficiency symptom survey (CISS) which was administered by parents. Measurements were compared before and after treatment and between groups using non-parametric statistics with significance level at p<0.05.

Results : Nineteen children (mean age 9.9 yrs, F:12) were included. 10 children (mean age 9.6 yrs, F:5) were allocated to ADD whereas 9 (mean age 10.3 yrs, F:7) were allocated to VT. Baseline measurements of MAF-R, MAF-L, BAF and CISS were 2.5 cpm, 2.6 cpm, 1.8 cpm and 27.5, respectively in the ADD group, and 2.2 cpm, 2.0 cpm, 1.5 cpm and 29.2, respectively in the VT group. There were no significant differences between groups at baseline. After 6 weeks of treatment the average change of MAF-R, MAF-L, BAF and CISS was +5.4 cpm, +5.2 cpm, +4.9 cpm and -9.8, respectively in the ADD group, and +9.4 cpm, +8.8 cpm, +10.8 cpm and -17.8, respectively in the VT group. All changes within groups were significant. Comparison of changes between groups showed a significantly greater effect of treatment with ADD compared to SP for BAF (p=0.008) and CISS (p=0.017).

Conclusions : In children with newly diagnosed accommodative infacility, active treatment with accommodation exercises for 6 weeks gives greater short-term relieve of symptoms and improvement of binocular accommodative facility compared to passive treatment with spectacle correction with a weak plus addition. Further studies on the sustained effect are warranted.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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