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The aim of this work was to study the relation between subjective symptoms at near and ocular accommodation in terms of the amplitude of accommodation and the relative accommodation. A secondary aim was to discuss the diagnosis of accommodative insufficiency. The chosen cohort was examined on two occasions with 1.8 years in between. The first examination included 72 children, 43 boys (mean age 8.1 years, ranging from 5.8 to 9.8) and 29 girls (mean age 8.3 years, ranging from 6.2 to 10.0). The second examination included 59 of these children, 34 boys (mean age 9.9 years, ranging from 7.8 to 11.7) and 25 girls (mean age 10.1 ranging from 8.0 to 11.8). Subjective symptoms at near work (headache, asthenopia, floating text, facility problems) were recorded and the amplitude and the relative accommodation, both positive and negative, were measured. The result from the questionnaire showed that at the first examination more than one-third of the children (34.7%) reported at least one subjective symptom when doing near work and 42.4% at the second examination. No symptoms were found among children younger than 7.5 years, but for children between 7.5 and 10 years old at the first examination, the prevalence of at least one symptom was 47.2%. At the second examination, symptoms were reported also for the youngest children, i.e. from the age of 8 years. The discrimination ability for the amplitude of accommodation, both monocular and binocular, was significant. In the first examination the difference between the mean for the two groups (i.e. with and without at least one symptom) was around 2.00 D monocular and 3.00 D binocular. Corresponding figures from the second examination was a difference between the mean for the two groups of around 3.50 D monocular and nearly 4.00 D binocular. We suggest that accommodation measurements should be performed more routinely and regularly, maybe as screening, especially in children over 8 years of age. [ABSTRACT FROM AUTHOR]

The aim of this study was to measure the amplitude of accommodation for junior level school children and to compare it with age-expected values. A junior level school in Göteborg, Sweden, was randomly chosen and the amplitude of accommodation among 76 children aged 6–10 years was examined using DondersÕ push-up method. The results showed lower amplitude than expected in a large group of children. Results also showed lower amplitude than previously reported for this age group, especially under monocular conditions, which revealed an average dioptric difference from the expected value of -3.60 dioptres (D) right eye (mean 12.40 D, median 12.00 D, S.D. 3.7 D) and -3.50 D left eye (mean 12.50 D, median 12.70 D, S.D. 3.8 D) (p < 0.001 for both eyes). Consequently, we conclude that it cannot be assumed that the amplitude of accommodation is in the expected amplitude range for all children of these ages. [ABSTRACT FROM AUTHOR]

The effects of accommodative facility training were evaluated by comparing training with pIano lenses and ±2.00 D lens flipper sets. Thirteen children with symptoms and signs of accommodative dysfunction were included in the study. Seven started with 2 weeks of pIano lens training before proceeding to traditional dioptric flipper training; later, one patient from this group was lost to follow-up. The remaining six children used powered flipper training from the start. The positive (PRA) and negative relative accommodation (NRA) were examined every second week. During the initial training period both the PRA and the NRA decreased in the sham treatment group (P= 0.010 and P= 0.102, respectively), while the PRA and the NRA increased during the dioptric training in both groups (P = 0.102 and P = 0.033, respectively). The result of this study indicates that accommodative facility training has a real effect on the amplitude of relative accommodation in patients with impaired relative accommodation. [ABSTRACT FROM AUTHOR]