Methods to diagnose the accommodative state

Abstract

Accommodation was known from the 18th Century with the Helmholtz theory and it was a starting point to study the accommodative state, alterations, and different diagnosis methods. Optometry has relevant functions in visual and ocular health; one of them is to evaluate the accommodative state since its alteration is one of the main reasons of visual discomfort that patients’ daily activities torpid. The accommodative state is traditionally evaluated measuring amplitude and flexibility of accommodation. However, regarding some studies, accommodative response is important because a patient may present asthenoptic symptoms and an accommodative problem even with normal amplitude and flexibility values. Donders and Sheard methods valuate accommodation amplitude, but they present disadvantages such overestimation of accommodation amplitude in the first one, and underestimation of amplitude in the second one. There are also some discrepancies among researchers regarding accommodation amplitude normal patterns, and it has been shown that accommodation flexibility values are different according to patients’ age. In this review it is necessary, then, to know different methods and normal values for amplitude accommodation, flexibility, relative accommodation and accommodative response; since they are fundamental for the examiner make an appropriate diagnosis and treatment of accommodative alterations.