Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects

Background: Guidelines for predicting the amplitude of accommodation (AA) sometimes are based on measurements for the subjective push-up-to-blur method. However, the push-up-to-blur method often overestimates the accommodative response. Another method that is commonly used to measure AA is the minus...

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Main Authors: Mbali Z.G. Ndlovu, Kgaogelo T. Mothapo, Makgatha H. Kgatla, Muano S. Tshihomu, Solani D. Mathebula
Format: Article
Language:English
Published: AOSIS 2019-06-01
Series:African Vision and Eye Health
Subjects:
Online Access:https://avehjournal.org/index.php/aveh/article/view/491
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author Mbali Z.G. Ndlovu
Kgaogelo T. Mothapo
Makgatha H. Kgatla
Muano S. Tshihomu
Solani D. Mathebula
author_facet Mbali Z.G. Ndlovu
Kgaogelo T. Mothapo
Makgatha H. Kgatla
Muano S. Tshihomu
Solani D. Mathebula
author_sort Mbali Z.G. Ndlovu
collection DOAJ
description Background: Guidelines for predicting the amplitude of accommodation (AA) sometimes are based on measurements for the subjective push-up-to-blur method. However, the push-up-to-blur method often overestimates the accommodative response. Another method that is commonly used to measure AA is the minus-lens-to-blur technique. This method is routinely conducted at a viewing distance of 40 cm, with the addition of 2.50 D to correspond with the initial accommodative stimulus. Aim: Although the AA measured using the minus-lens-to-blur method can be performed with the target at 40 cm, this study investigated changing the viewing distance and then comparing the means for participants at 600 cm (6 m), 40 cm (0.4 m) and 33 cm (0.33 m). In this manner, the possibility of using the AA measured at 6 m to estimate AA at 40 cm or 33 cm could be explored. Setting: The study was conducted in the Optometry Department, University of Limpopo. Methods: The AA was measured using the minus-lens-to-blur method over the distance correction when the target was held at viewing distances of 6 m, 40 cm and 33 cm. The minus lens power used to stimulate accommodation was gradually increased in 0.25 D steps. All measurements were performed using a phoropter. Results: The mean AA was 8.46 ± 2.07 D for 6 m, 10.62 ± 2.05 D for 40 cm and 11.31 ± 2.07 D for 33 cm. The measured AA at 6 m was significantly lower than that with the target at 40 cm and 33 cm measurement, p < 0.01. The Bland–Altman plots showed that there was a weaker agreement between the measured AA with the target at 6 m and near; however, there was a better agreement when the target was at 40 cm or 33 cm. Conclusion: The findings of this study suggest that the results for AA measured using the minus-lens-to-blur method at 6 m are not comparable to the results with the target at 40 cm or 33 cm. Even though there was a positive correlation between 6 m and the near distances, the results were not interchangeable or useful to calculate AA at 40 cm and 33 cm. The difference between the AA measured with the target at 40 cm and 33 cm can vary on average by about 0.70 D.
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spelling doaj.art-aec5a7e0e2584eea9ff06f574e758a4a2022-12-22T01:55:29ZengAOSISAfrican Vision and Eye Health2413-31832410-15162019-06-01781e1e710.4102/aveh.v78i1.491387Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjectsMbali Z.G. Ndlovu0Kgaogelo T. Mothapo1Makgatha H. Kgatla2Muano S. Tshihomu3Solani D. Mathebula4Department of Optometry, University of Limpopo, SovengaDepartment of Optometry, University of Limpopo, SovengaDepartment of Optometry, University of Limpopo, SovengaDepartment of Optometry, University of Limpopo, SovengaDepartment of Optometry, University of Limpopo, SovengaBackground: Guidelines for predicting the amplitude of accommodation (AA) sometimes are based on measurements for the subjective push-up-to-blur method. However, the push-up-to-blur method often overestimates the accommodative response. Another method that is commonly used to measure AA is the minus-lens-to-blur technique. This method is routinely conducted at a viewing distance of 40 cm, with the addition of 2.50 D to correspond with the initial accommodative stimulus. Aim: Although the AA measured using the minus-lens-to-blur method can be performed with the target at 40 cm, this study investigated changing the viewing distance and then comparing the means for participants at 600 cm (6 m), 40 cm (0.4 m) and 33 cm (0.33 m). In this manner, the possibility of using the AA measured at 6 m to estimate AA at 40 cm or 33 cm could be explored. Setting: The study was conducted in the Optometry Department, University of Limpopo. Methods: The AA was measured using the minus-lens-to-blur method over the distance correction when the target was held at viewing distances of 6 m, 40 cm and 33 cm. The minus lens power used to stimulate accommodation was gradually increased in 0.25 D steps. All measurements were performed using a phoropter. Results: The mean AA was 8.46 ± 2.07 D for 6 m, 10.62 ± 2.05 D for 40 cm and 11.31 ± 2.07 D for 33 cm. The measured AA at 6 m was significantly lower than that with the target at 40 cm and 33 cm measurement, p < 0.01. The Bland–Altman plots showed that there was a weaker agreement between the measured AA with the target at 6 m and near; however, there was a better agreement when the target was at 40 cm or 33 cm. Conclusion: The findings of this study suggest that the results for AA measured using the minus-lens-to-blur method at 6 m are not comparable to the results with the target at 40 cm or 33 cm. Even though there was a positive correlation between 6 m and the near distances, the results were not interchangeable or useful to calculate AA at 40 cm and 33 cm. The difference between the AA measured with the target at 40 cm and 33 cm can vary on average by about 0.70 D.https://avehjournal.org/index.php/aveh/article/view/491amplitude of accommodationblurdioptreminus-lens-to-blur methodpush-up-to-blur methodsubjective method
spellingShingle Mbali Z.G. Ndlovu
Kgaogelo T. Mothapo
Makgatha H. Kgatla
Muano S. Tshihomu
Solani D. Mathebula
Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects
African Vision and Eye Health
amplitude of accommodation
blur
dioptre
minus-lens-to-blur method
push-up-to-blur method
subjective method
title Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects
title_full Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects
title_fullStr Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects
title_full_unstemmed Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects
title_short Agreement between distance and near minus-lens-to-blur amplitude of accommodation in pre-presbyopic subjects
title_sort agreement between distance and near minus lens to blur amplitude of accommodation in pre presbyopic subjects
topic amplitude of accommodation
blur
dioptre
minus-lens-to-blur method
push-up-to-blur method
subjective method
url https://avehjournal.org/index.php/aveh/article/view/491
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