Accommodation in patients from five to twelve years with mild to moderate refractive amblyopia: a pilot test

Abstract

<em><strong>Objective:</strong></em> determine the accommodative state in refractive amblyopia patients between five and twelve years old. <em><strong>Methods:</strong></em> A sample of fifteen refractive amblyopic children was included, and a control group of fifteen children between five and twelve years of age. The control group patients were required to have a maximum VA of 0.32 LogMar without correction, both at distance and near vision, and an uncorrected refractive error. It took into account individuals with mild and moderate refractive amblyopia of both anisometropic and isometropic types, with a minimum VA of 0.4 and a maximum VA of 0.8 LogMar with appropriate optical correction. Subjects suffering from organic ocular alterations, cognitive problems, diagnosis of strabismus, strabismus surgery or trauma were excluded, as well as patients who had attended or at the time were attending vision therapy. The accommodative state was evaluated in each patient, measuring the Lag of accommodation, the flexibility and the amplitude of accommodation (AA) with three subjective (PU, MPD and ML) and one objective technique (MODAA, for its initials in Spanish). <em><strong>Results:</strong></em> AA measured with the four methods was statistically significantly lower in amblyopic patients (p < 0.05), being the difference more pronounced with the use of ML (4.72 D). However, with the objective MODAA technique, which has shown high reliability, the differences were not clinically significant (0.47). Conclusions: The accommodative state of refractive amblyopia patients between five and twelve years is lower when subjective methods are employed. The most common alteration was insufficiency of accommodation.