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Clinical science
Asymmetrical accommodation in hyperopic anisometropic amblyopia
  1. Sonia Toor1,
  2. Anna M Horwood2,3,
  3. Patricia Riddell2
  1. 1 Academic Unit of Ophthalmology and Orthoptics, University of Sheffield, Sheffield, UK
  2. 2 Infant Vision Laboratory, School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
  3. 3 Orthoptic Department, Royal Berkshire Hospital, Reading, UK
  1. Correspondence to Dr Sonia Toor, Academic Unit of Ophthalmology and Orthoptics, Faculty of Medicine, Dentistry and Health, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK; sonia.toor{at}sheffield.ac.uk

Abstract

Background/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 4–8 years with hyperopic anisometropic amblyopia and 13 controls (group age-matched) while they viewed a detailed target moving in depth.

Results Without spectacles, only 5 (19%) anisometropes demonstrated symmetrical accommodation (within the 95% CI of the mean gain of the sound eye of the anisometropic group), whereas 21 (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) while 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.

  • optics and Refraction
  • Vision
  • child health (paediatrics)

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bjophthalmol-2017-310282

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    Footnotes

    • Contributors All authors made substantial contributions to the research. AH was the principal investigator. ST collected the data and drafted the manuscript. All authors contributed to the design, analysis and interpretation of the data, and in the revising of the manuscript.

    • Funding This research was supported by a UK Medical Research Council Clinical Scientist Fellowship awarded to AH (G0802809).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval National Health Service.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data reported in this article are openly available from Zenodo at http://dx.doi.org/10.5281/zenodo.996512

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