Asymmetrical accommodation in hyperopic anisometropic amblyopia
Toor, S., Horwood, A. M.
It is advisable to refer to the publisher's version if you intend to cite from this work. See Guidance on citing. To link to this item DOI: 10.1136/bjophthalmol-2017-310282 Abstract/SummaryBackground/Aims: To investigate the presence of asymmetrical accommodation in hyperopic anisometropic amblyopia. Methods: Accommodation in each eye and binocular vergence were measured simultaneously using a PlusoptiX SO4 photorefractor in 26 children aged 4 to 8 years with hyperopic anisometropic amblyopia and 13 controls (group age-matched) whilst they viewed a detailed target moving in depth. Results: Without spectacles, only 5 (19%) of anisometropes demonstrated symmetrical accommodation (within the 95%CI of the mean gain of the sound eye of the anisometropic group), whereas 81% demonstrated asymmetrical accommodation. Of those, 15 (58%) showed aniso-accommodation and 6 (23%) demonstrated “anti-accommodation” (greater accommodation for distance than for near). In those with anti-accommodation the response gain in the sound eye was (0.93 ±0.20) whilst that of the amblyopic eye showed a negative accommodation gain of (-0.44 ±0.23). Anti-accommodation resolved with spectacles. Vergence gains were typical in those with symmetrical and asymmetrical accommodation. Conclusion: The majority of hyperopic anisometropic amblyopes demonstrated non-consensual asymmetrical accommodation. Approximately one in four demonstrated anti-accommodation.
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