Accommodative state in amblyopic and non-amblyopic patients from 5 to 12 years of age

Abstract

<em><strong>Objective:</strong></em> To determine difference in the accommodative state between refractive amblyopic and non-amblyopic patients from 5 to 12 years of age. <em><strong>Methods:</strong></em> The sample included 142 children (46 with refractive amblyopia and 96 non-amblyopic) between 5 and 12 years of age the accommodative state was evaluated in each one of them by determining the accommodative lag with Nott retinoscopy, accommodative flexibility with flippers, and the amplitude of accommodation with a subjective (MPD) and an objective technique (MODAA). <em><strong>Results:</strong></em> A statistically significant difference was found between amblyopic and non-amblyopic subjects in the lag of accommodation (0.22, p < 0.001), accommodative flexibility (1.5 cycles, <em>p</em> < 0.001), and the amplitude of accommodation 1.6 D (<em>p</em> < 0.001), using the MPD technique. With MODAA, there was no statistically significant difference between amblyopic and non-amblyopic children for the dominant eye (0.02 D, <em>p</em> = 0.893), while for the non-dominant eye the difference was 0.38 D. <em><strong>Conclusions:</strong></em> Using objective methods to evaluate these three functions of the accommodative state in patients with mild to moderate refractive amblyopia, the values obtained were within the normal range. However, when compared with non-amblyopic patients, a statistically significant difference was detected, which does not necessarily lead to the diagnosis of amblyopic patients with inadequate accommodation. The most altered accommodative function in the non-dominant eyes of patients with refractive amblyopia was accommodative flexibility. In patients with refractive amblyopia, alteration of the accommodative system is directly proportional to the degree of anisometropia.
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Keywords

amplitude of accommodation
refractive amblyopia
MODAA
lag
accommodative flexibility
insufficiency of accommodation