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Decreased accommodation during decompensation of distance exotropia

Horwood, A. M. ORCID: and Riddell, P. M. ORCID: (2012) Decreased accommodation during decompensation of distance exotropia. British Journal of Ophthalmology, 96 (4). pp. 508-513. ISSN 0007-1161

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To link to this item DOI: 10.1136/bjophthalmol-2011-300138


Objective. Disparity cues can be a major drive to accommodation via the CA/C (convergence accommodation to convergence) linkage but, on decompensation of exotropia, disparity cues are extinguished by suppression, so this drive is lost. This study investigated accommodation and vergence responses to disparity, blur and proximal cues in a group of distance exotropes aged between 4-11 years both during decompensation and when exotropic. Methods. 19 participants with distance exotropia were tested using a PlusoptiXSO4 photorefractor set in a remote haploscopic device which assessed simultaneous vergence and accommodation to a range of targets incorporating different combinations of blur, disparity and proximal cues at four fixation distances between 2m and 33cm. Responses on decompensation were compared to those from the same children when their deviation was controlled. Results. Manifest exotropia was more common in the more impoverished cue conditions. When decompensated for near, mean accommodation gain for the all-cue (naturalistic) target reduced significantly (p<0.0001), with resultant mean under-accommodation of 2.33D at 33cm. The profile of near cues usage changed after decompensation, with blur and proximity driving residual responses, but these remaining cues did not compensate for loss of accommodation caused by the removal of disparity. Conclusions. Accommodation often reduces on decompensation of distance exotropia as the drive from convergence is extinguished, providing a further reason to try to prevent decompensation for near.

Item Type:Article
Divisions:Life Sciences > School of Psychology and Clinical Language Sciences > Development
Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
Life Sciences > School of Psychology and Clinical Language Sciences > Perception and Action
ID Code:22561
Uncontrolled Keywords:Distance exotropia accommodation decompensation AC/A CA/C; vision; child health (paediatrics); treatment other; optics and refraction; visual perception;experimental and laboratory
Publisher:BMJ Publishing Group

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