Individual data on visual acuity and accommodation after training of accommodation under control of convergence in patients with myopia and hypermetropia

© 2016 S. I. Rychkova, M. A. Gracheva, H. P. Tahchidi

Institute for Information Transmission Problems (Kharkevich Institute), RAS 127051 Moscow, B.Karetny per., 19
Russian National Research Medical University named after N.I.Pirogov 117997 Moscow, ul.Ostrovitjanova, 1.

Received 15 May 2015

The individual data on visual acuity and accommodation range were compared before and after training of accommodation under control of convergence in patients with myopia (N = 33) and hypermetropia (N = 31). The training course consisted of 10 sessions of exercises, during which the patients were instructed to recognize visual stimuli of different sizes, presented at different distances from the eyes. During the session, we gradually changed the strength of corrective lenses under the correct control of convergence of the eye axes on the screen with the visual stimulus. The effect of training was assessed at the three observation distances: 0.5, 1.0 and 5.0 m. The majority of patients with both myopic and hypermetropic refraction had the highest positive effect at the viewing distance of 1 m. However, the individual data differed significantly. The results of the training depended on the initial level of visual acuity, accommodation range, the degree of ametropia and the presence of astigmatism. The most significant improvement of visual acuity was observed in patients with slight degree of ametropia without astigmatism. The improvement of visual acuity was usually combined with the improvement in accommodative ability.

Key words: accommodation, visual acuity, myopia, hypermetropia, convergence, functional correction

Cite: Rychkova S. I., Gracheva M. A., Tahchidi H. P.. Individualnye pokazateli rezultativnosti trenirovok akkomodatsii v usloviyakh kontrolya konvergentsii u patsientov s miopiei i gipermetropiei [Individual data on visual acuity and accommodation after training of accommodation under control of convergence in patients with myopia and hypermetropia]. Sensornye sistemy [Sensory systems]. 2016. V. 30(1). P. 42-52 (in Russian).

References:

  • Volkov V.V., Kolesnikova L.N. On the treatment of spasm of accommodation, which is not directly associated with weakness of the ciliary muscle // J. Ophthalmol. 1976. No 1. P. 50–52 [in Russian].
  • Dashevskiy A.I. Pseudomyopia. M.: Publ. “Medicine” 1973. 152 p. [in Russian].
  • Zayani Nabil, Voronzova T.N., Brzheskiy V.V. Combination therapy of spasm of accommodation in children // Ophthalmol. Statements. 2011. V.4, No 1. P. 23–27 [in Russian].
  • Kaspranskiy R.R., Muratova E.A., Yakushev A.G. The use of videooculography to assess a comfortable distance to the target // Biomechanics of the eye / Ed. Iomdina E.N., Koshits I.N. M.: Publ. MSRI named after Helmholtz. 2005. P. 166–168 [in Russian].
  • Katargina L.A. Accommodation: a Guide for doctors / Ed. Katargina L.A. M.: Publ. “April”, 2012. 136 p. [in Russian].
  • Kornyushina T.A., Ibragimov V.A., Kashchen- ko T.P. Magaramova M.D. Accommodative asthenopia in schoolchildren with intermediate and moderate ametropia // Russian Pediatric Ophthalmol. 2011. No 1. P. 20–21 [in Russian].
  • Moguilev L.N. Binarimetr. “Discoveries, inventions, industrial designs, trademarks”. Copyright certificate 596220 // B. I. 1978. V. 70. No 8. P. 14–15 [in Russian].
  • Rozhkova G.I., Tokareva V.S. Tests and tables for the assessment of visual abilities. M.: Publ. “VLADOS”. 2001. 102 p. [in Russian].
  • Rozhkova G.I., Tokareva V.S. Nikolaev D.P., Ognivov V.V. Main types of visual acuity dependence on distance in young and old adults confirmed by means of discriminant analysis // Sensory Systems. 2004. V. 18. No 4. P. 330– 338 [in Russian].
  • Rychkova S.I., Rozhkova G.I. Postoperative visual acuity, accommodation and optimal optical correction in squint patients // Sensory Systems. 2009. V.23. No 1. P. 24–39 [in Russian].
  • Rychkova S.I., Rozhkova G.I. Visual acuity for different observation distances with ametropia and artiphakia // Biomechanics of the eye / Ed. Iomdi- na E.N., Koshits I.N. M.: Publ. MSRI named after Helmholtz. 2009b. P. 24–29 [in Russian].
  • Tarutta E. P., Tarasova N.A. The state of the habitual tone and the resting tone of accommodation in children and adolescents on the background of the instrumental treatment of myopia // Russian Оphthalmol. J. 2012. No 2. P. 59–62 [in Russian].
  • Shapovalov S.L., Milyavskaya T.I., Ignatyev S.A. Accommodation of the eye and its disorders. М.: Publ. МIК, 2011. 184 p. [in Russian].
  • Allen P.M, O’Leary D.J. Accommodation functions: co-dependency and relationship to refractive error // Vision Res. 2006. V. 46. P. 491–505.
  • Buehren T., Collins M.J. Accommodation stimulus- response function and retinal image quality // Vision Res. 2006. V. 46. P. 1633–1645.
  • Berntsen D.A., Sinnott L.T., Mutti D.O., Karla Zadnik K. Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction // Vision Res. 2011. V. 51 No 9. P. 1039–1046.
  • Davies L.N., Mallen E.A. Influence of accommodation and refractive status on the peripheral refractive profile // Br. J. Ophthalmology. 2009. V. 93. P. 1186–1190.
  • Judge S.J., Flavell M.J. Mechanics of accomodation of the human eye // Vision Res. 1999. V. 39. P. 1591–1595.
  • Lundstrom L., Mira-Agudelo A., Artal P. Peripheral optical errors and their change with accommodation differ between emmetropic and myopic eyes // J. Vision. 2009. V. 9. No 17. P. 1–11
  • Mutti D.O., Mitchell G.L., Jones L.A., Friedman N.E., Frane S.L., Lin W.K., Moeschberger M.L., Zadnik K. Accommodation, acuity, and their relationship to emmetropization in infants // Optom. Vis. Sci. 2009. V. 86 No 6. P. 666–676.
  • Phillips J.R. Monovision slows juvenile myopia progression unilaterally // Br. J. Ophthalmol. 2005. V. 89. No 1196–200.
  • Heron G., Furby H.P., Walker R.J., Lane C.S., Judge O.J.E. Relationship between visual acuity and observation distance // Ophthal. Physiol. Opt. 1995. V. 15. No 1. P. 23–30.
  • Tarczy-Hornoch K. Modified Bell Retinoscopy: Measuring Accommodative Lag in Children // Optom. Vis. Sci. 2009. V. 86. No 12. P. 1337–1345.
  • Vasudevan B., Ciuffreda K.J., Ludlam D.P. Accommoda- tive training to reduce nearwork-induced transient myo- pia // Optom. Vis. Sci. 2009. V. 86. No 11. P. 1287–1294.
  • Weizhong L., Zhikuan Y., Wen L., Xiang C., Jian G. A longitudinal study on the relationship between myopia development and near accommodation lag in myopic children // Ophthalm. Physiol. Opt. 2008. V. 28. No 1. P. 57–61.