Jaclyn A. Benzoni OD, MS, FAAO; Mark Rosenfield MCOptom, PhD, FAAO

Clinical Amplitude of Accommodation in Children between 5 and 10 Years of Age

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Background: While there have been extensive

studies of the amplitude of accommodation (AA)

in adults, estimates of AA from studies in children

between 5 and 10 years of age vary widely with some

of the data being contradictory. Further, since values

of AA are used for the diagnosis of several conditions

including accommodative insufficiency (AI), it is

important to able to compare clinical findings with

age-defined norms.


Methods: The present study was performed on

60 asymptomatic children between 5 and 10 years of

age. Each child was refracted for distance viewing, and

both push-up (PU) and push-down (PD) amplitudes

were recorded monocularly using a Royal Air Force

(RAF) nearpoint rule. Four readings (2 PU and 2 PD)

were taken on each subject. The same procedures were

also carried out on 38 adult subjects between 20 and

50 years of age.


Results: The mean findings (average of PU and

  1. PD) declined from 16.2D (SEM=1.7D) at 5 years of

age to 12.4D (SEM=1.4D) at 10 years of age. A twophase regression was observed, with a rapid decline

between 5 and 7 years of age, but minimal change

between 7 and 10 years of age.


Conclusions: Both the pediatric and adult data is

broadly similar to the classic findings of Donders and

Duane. However, a relatively high percentage (36%)

of children met the most commonly adopted criterion

for AI, suggesting that this standard may need to be

reexamined in this particular age group


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