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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


Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.

Amanda T.

Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.

Alexa H.

Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!

Charlotte M.

Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

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Seems much less frustrated with life

Reads non-stop and fast

Spelling abilities have been hugely improved

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When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!

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