Tsuneyoshi Y, Negishi K, Tsubota K. Importance of Accommodation and Eye Dominance for Measuring Objective Refractions.
Am J Ophthalmol 2017;
177:69-76. [PMID:
28237412 DOI:
10.1016/j.ajo.2017.02.013]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/12/2017] [Accepted: 02/15/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE
To explore factors affecting the difference between objective refractive data measured under monocular closed-field viewing and binocular open-field viewing.
DESIGN
Prospective observational case series.
METHODS
setting: Institutional.
STUDY POPULATION
Twenty-nine healthy volunteers (58 eyes; mean age, 38.4 ± 10.0 years; range, 25-60 years).
OBSERVATION PROCEDURES
Objective monocular refractions (MR) measured with the Nidek Auto Ref/Keratometer ARK-730A; objective binocular refractions (BR) and objective accommodative amplitude (AA) measured with the Grand Seiko Auto Ref/Keratometer WAM-5500; ocular dominance measured using the hole-in-the-card test; presence and magnitude of far/near (30 cm) phoria evaluated by the cover test and alternating cover test using a prism bar.
MAIN OUTCOME MEASURE
The difference between objective refractive data measured under monocular closed-field viewing and binocular open-field viewing.
RESULTS
The spherical equivalent (SE) of the BR was significantly (P < .001) more hyperopic by 0.51 ± 0.33 diopter (D) than the MR. The difference (BR minus MR) tended to decline with increasing age and decreasing AA (r = -0.231, P = .08; r = 0.223, P = .092, respectively). The correlation between age and difference in SE was significant in dominant eyes (r = -0.372, P = .047) but not in nondominant eyes (r = -0.102, P = .60). In nondominant eyes, the amount of near phoria was correlated significantly (r = 0.403, P = .03) with the difference in SE. The correlation was strong (r = 0.598, P = .01) in 17 subjects with more than 3 D of AA.
CONCLUSIONS
Binocular assessment of refraction is important for precise refractive therapy.
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