Amplitude of Accommodation Measured by Closed-Field Autorefractometer in Children With Bilateral High Hyperopia

OBJECTIVES: To assess the amplitude of accommodation by autorefractometer in children with bilateral high hyperopia.
METHODS: The records of children with bilateral high hyperopia (+6.00 diopter and above) were investigated. Age, amplitude of accommodation (AA) values and pupil size (PS) changes measured by closed-field autorefractometer (Tonoref III), spherical equivalent (SE), astigmatism, presence of amblyopia, strabismus, and stereopsis were noted. Age-matched emmetropic children were also assessed as control group. Comparisons were statistically performed.
RESULTS: The mean ages of high hyperopia (n=32) and control groups (n=32) were not statistically different (p=0.905). Mean SE values were different in both eyes between groups (p<0.001, p<0.001, right and left eyes, respectively). Mean AA in both eyes were different between groups (p=0.017, p=0.02, right and left eyes, respectively). AA differences between two eyes and pupil size measurements in both eyes (right and left) were not different (p=0.90, p=0.576, p=0.35, respectively). Presence of strabismus and amblyopia were higher in hyperopia group and stereoacuity was better in control group. In hyperopia group, there was statistical difference between patients with and without strabismus regarding to mean AA (p=0.03).
DISCUSSION AND CONCLUSION: Accommodative amplitude, measured by a closed-field autorefractometer (Tonoref III) was lower in bilateral high hyperopic children. AA difference between two eyes and pupil sizes during accommodation were not different between high hyperopic patients and emmetropic controls. High hyperopic patients with strabismus were found to have better accommodative amplitude.

Keywords: Amplitude of accommodation, high hyperopia, closed-field autorefractometer, strabismus, pupil size