儿童屈光不正与各屈光参数关系

目的：研究眼轴、角膜屈光力、晶状体屈光力与儿童屈光不正的关系。

方法：通过睫状肌麻痹检影验光及光学生物测量仪(IOL-Master)获得44例88眼的屈光不正度数、眼轴、角膜屈光力、前房深度等参数,经计算得到晶状体度数。按屈光不正度数分为远视组、正视组、近视组,直线相关与回归比较年龄和屈光不正与各屈光参数之间的关系。

结果：受试者44例88眼,平均年龄9.04±2.39岁,等效球镜(SE)-3.50～+8.75D; 远视组眼轴比近视正视组短(P<0.05),远视组晶状体屈光力明显低于近视正视组(P<0.05),三组间角膜屈光力和前房深度无明显差别。本研究发现年龄与等效球镜(SE)之间成负相关; 眼轴与年龄成正相关; 年龄与晶状体屈光力成正相关; SE与眼轴成负相关; SE与晶状体屈光力有负相关关系。

结论：儿童随年龄增长,SE向近视发展,眼轴变长,晶状体屈光力增强; SE越偏远视,眼轴越短、晶状体屈光力越弱。     

6-48月龄婴幼儿Spot屈光度异常结果分析

目的：分析6-48月龄婴幼儿Spot屈光异常情况,为婴幼儿屈光不正矫正及弱视早期防治提供依据。

方法：对6-48月龄婴幼儿使用Spot双目视力筛查仪进行自然状况下验光,根据Spot屈光筛查仪4岁以下儿童转诊标准,收集屈光异常婴幼儿临床资料; 使用睫状肌麻痹剂视网膜检影验光,并对验光结果进行统计分析。

结果：根据转诊标准共收集Spot屈光度异常婴幼儿168例336眼。其中远视及散光异常占比高,分别为38.4%和28.6%,而近视占比低(12.2%)。168例Spot屈光度异常婴幼儿中,屈光参差(≥1.00 D)共90例,其中散光性屈光参差41例(45.6%)、远视性屈光参差33例(36.7%),近视性屈光参差16例(17.8%)占比最少。共109例Spot屈光度异常婴幼儿完成睫状肌麻痹剂视网膜检影验光。对其Spot屈光度与睫状肌麻痹后检影验光结果差异及相关性分析结果显示,两者散光度差异为0.34±0.64 D(P<0.001),远视度差异为-2.10±1.27 D(P<0.001),近视度差异为-0.43±0.91 D(P=0.023); 虽然二者结果存在统计学差异,但二者散光度、远视度及近视度均呈正相关(r=0.694、0.762、0.909)。

结论：6-48月龄婴幼儿Spot屈光异常主要以散光、远视异常和屈光参差为主,近视异常较少; 对Spot筛查异常者应进一步睫状肌麻痹剂视网膜检影验光,给予配镜矫正,有效防止婴幼儿屈光性弱视。     

翼状胬肉逆行切除术1例

目的：探讨屈光不正性弱视的程度、类别、治疗年龄与疗效的关系,为临床治疗提供参考。

方法：屈光不正性弱视患儿186例272眼,随机分为远视性弱视组、近视性弱视组和散光性弱视组进行综合治疗,并对弱视程度和治疗年龄进行疗效比较。治疗包括配戴合适眼镜、遮盖健眼或交替遮盖、精细目力作业训练及弱视治疗仪的应用。

结果：远视性弱视患者基本治愈率最高(78.5%),近视性弱视(64.6%),散光性弱视(52.6%),有显著性差异(P<0.05)。远视性弱视、轻度弱视及发病年龄小的弱视治疗效果好(P<0.05)。

结论：屈光不正性弱视的治疗效果与屈光状态、弱视程度、年龄有关。     

温州市区视力不良小学生屈光状态及相关因素

目的：研究视力不良小学生屈光状态及近视眼发病的相关因素,方法：随机抽取温州市视力不良的小学生4696名（有效眼9392眼）进行扩瞳视网膜检影验光,填写调查表,调查各年级小学生屈光状态及其相关因素。结果：本组小学生视力不良以屈光不正为主,占79．7％,其中近视性屈光不正最多,占48．9％,其次是散光25.6％。随学习阶段上升,近视患病率逐渐增高,屈光参差患病率23．7％,弱视患病率以远视性屈光参差最高,达97．9％。近视眼发病与遗传因素（20．19％）及环境、体质因素有关。结论：在小学生中普查视力和屈光状态,以早期发现屈光不正和弱视,进行及时防治,对控制小学生视力不良有重要意义。     

广东省阳江市区小学生视力及屈光状态调查分析

目的:了解小学生视力不良情况和屈光状态及其与近视发生发展的关系。方法:调查阳江市区12021名小学生的远视力,随机抽取304名视力不良学生进行散瞳视网膜检影,判断屈光状态,将所得结果比较分析。结果:视力不良发生率为24.89%,各年级差异有显著意义,女生发生率高于男生,各年级男女生的差异随学年的升高差异越显著;视力下降的程度也随学年的升高差异明显加重。屈光不正中以近视最多,占47.55%,远视性屈光不正的患病率随学年升高而下降,近视性屈光不正患病率则随学年升高逐渐增加。结论:引起小学生视力下降的主要原因是近视,做好近视防治工作,对控制小学生视力不良有重要意义。     

重庆酉阳县土家族青少年屈光不正及相关因素的流行病学调查

目的：了解重庆市酉阳县土家族青少年人群屈光不正的患病率及其影响因素。方法：横断面调查研究。采用分层整群抽样的方法,对重庆市酉阳县城镇和乡村各2所中学（初中和高中）的土家族青少年共973例进行眼科检查。通过电脑自动验光及1%环戊通滴眼液扩瞳后检影验光获得青少年的屈光状态,以调查问卷方式了解并分析近视发生的相关因素,包括户外活动时间、父母屈光状态等。采用Pearson卡方检验以及Pearson和Spearman相关性分析对数据进行处理。结果：近视（等效球镜度≤-0.50 D）、远视（等效球镜度≥+0.50 D）以及散光（柱镜度≤-0.50 D）的患病率分别为66.3%（645例）,17.5%（170例）和15.1%（147例）。高度近视检出25例,占总检出人数的2.6%。男生近视患病率（59.8%）显著低于女生（72.5%） （ χ 2 =17.53,P < 0.001）。城镇青少年近视患病率（77.9%）显著高于乡村青少年（51.6%） （ χ 2 =74.12,P < 0.001）。随着年龄增长,近视患病率逐渐升高（ χ 2 =84.70,P < 0.001）,远视患病率逐渐降低（ χ 2 =78.30,P < 0.001）。近视的土家族青少年中,父母双方均存在（ χ 2 =10.85,P=0.001）或单方存在（ χ 2 =56.01,P < 0.001）近视的概率显著高于非近视青少年。青少年户外活动时间与屈光状态呈显著正相关（r 2 =0.781,P < 0.001）。结论：重庆市酉阳县土家族青少年女性近视患病率较高;城镇青少年近视患病率高于乡村;近视发病与父母近视和户外活动时间相关。     

长沙市天心区应届高中毕业生视力与近视情况调查

目的：调查分析高中毕业生视力和近视情况,对近视防治工作提供参考依据。

方法：对2011/2013年长沙天心区8所高中的应届毕业学生10 593人进行视力和屈光状态检查,记录结果并进行统计学处理及分析。

结果：天心区应届高中毕业生近视眼患病率高达88.76%。2011年、2012年和2013年近视患病率分别为88.40%,88.91%和88.95%,无明显差异(P>0.05)。重点中学毕业生近视患病率较普通中学高, 女生近视患病率较男生高,差异均有统计学意义(P<0.01)。

结论：高中毕业生近视患病率高,应引起相关部门重视,制定有效措施防治近视的发生和进展。     

SPOT屈光筛查仪在6岁以下儿童视力筛查的转诊标准研究

目的：基于2021版美国斜视与小儿眼科协会(AAPOS)《儿童视力筛查指南》,修订SPOT屈光筛查仪在6岁以下儿童的转诊标准,并评估其准确性。

方法：纳入2022-01/2023-04在南京市雨花台区妇幼保健所就诊的儿童,进行SPOT屈光筛查仪、睫状肌麻痹检影验光等检查,并根据AAPOS指南定义具有弱视危险因素(ARFs)及有临床意义屈光不正(VSRE)的目标人群。使用受试者工作曲线计算最佳转诊标准,并与厂商标准、吴标准、Peterseim标准进行对比。

结果：共有959名儿童接受检查,其中<4岁组342人,≥4岁组617人。<4岁组的最佳转诊标准为：近视≤-2.75D、远视≥+2.25D、散光≤-2.75D、屈光参差≥1.00D; ≥4岁组为近视≤-1.75D、远视≥+2.00D、散光≤-2.25D、屈光参差≥1.00D; 其约登指数分别为0.38与0.52,均高于其他标准。

结论：采用新的6岁以下儿童屈光筛查转诊标准,其准确性较高,优于既往其他标准,能为儿童眼保健工作提供有益参考。     

河北省眼科医院门诊屈光不正患者的临床分析

目的：对河北省眼科医院门诊1 500例2 840眼屈光不正患者进行临床分析,为屈光不正患者的诊断、治疗和预防提供理论依据。

方法：选取河北省眼科医院2013-06/2014-07门诊屈光不正患者1 500例2 840眼,所有患者使用Topcon RM-8800电脑验光仪进行客观验光,使用Topcon综合验光仪主观验光,两者结合确定屈光度。并观察近视散光的屈光度与轴分布、远视散光的屈光度与轴分布、散光患者年龄与散光轴的分布。随机选取150例患者测量角膜曲率、前房深度、眼轴长度等静态屈光指标以及调节幅度、负相对调节、正相对调节、调节灵敏度等动态屈光指标,并与正常人群对比。

结果：所有患者屈光不正类型主要为单纯性近视、单纯近视散光、复性近视散光、单纯性远视、单纯远视散光、复性远视散光和混合散光,比例分别为38.99%、3.27%、23.94%、4.68%、1.34%、13.52%、15.25%; 近视散光共773眼,近视散光屈光度-0.25～-0.50、-0.75～-1.00、-1.25～-1.50、-1.75DS以上人数比例分别为31.05%、38.55%、16.56%、13.84%; 远视散光共421眼,远视散光屈光度0.25～0.50、0.75～1.00、1.25～1.50、>1.75DS人数比例分别为26.60%、24.94%、16.63%、31.83%。150例300眼患者静态屈光指标中,角膜曲率为41.23±2.43φ/D、前房深度为3.71±0.43mm、眼轴长度23.45±1.43mm; 动态屈光指标中,调节幅度10.56±2.32D、负相对调节2.31±0.47D、正相对调节-1.82±0.67D、调节灵敏度11.34±2.21D,各项动、静态屈光指标与正常人群比较,差异有统计学意义(P<0.05)。散光者1 194眼中,3～7、8～18、19～45、46～60岁合规则散光眼数所占比例分别为35.85%、11.98%、45.64%、6.53%; 150例300眼患者中,等效球镜≤-0.5D者152眼,等效球镜≥0.5D者48眼,-0.5～0.5D者100眼; 150例300眼正常人群等效球镜≤-0.5D者150眼,等效球镜≥0.5D者50眼,-0.5～0.5D者100眼。

结论：屈光不正患者1 500例2 840眼中,以单纯性近视、复性近视散光人数最多,近视散光者-0.25～-0.50、-0.75～-1.00DS屈光度区间人数最多,远视>1.75DS最多。散光者中,年龄越大不规则散光人数越多; 且屈光不正眼各项动、静态屈光指标与正常人群差异显著。     

兰州市中学生近视遗传度调查研究

目的 探讨中学生近视与遗传的关系.方法 选取兰州市某普通中学691名学生,进行视网膜检影验光,选取双眼屈光性质一致的656人作为研究对象,研究对象(学生)父母屈光状态采用电脑验光或问卷调查.计算近视遗传度,并研究子女-父母屈光状态的关系.结果 学生近视组一级亲属近视患病率为38.23%,对照组一级亲属近视患病率为19.39%.中学生近视遗传度为63.8%.父母屈光状态不同,子女屈光状态差异具有显著统计学意义(x2=92.168,P=0.000),父母双方近视、一方近视、均不近视子女发生近视的几率分别为:84.94%、76.60%、55.79%.结论 遗传因素在近视发病中起决定作用,环境因素起重要作用并受遗传因素影响.     

Symptomatic accommodative and binocular dysfunctions from the use of flat-panel displays

AIM: To determine the presence of symptomatic accommodative and non-strabismic binocular dysfunctions (ANSBD) in a non-presbyopic population of video display unit (VDU) users with flat-panel displays. METHODS: One hundred and one VDU users, aged between 20 to 34y, initially participated in the study. This study excluded contact-lens wearers and subjects who had undergone refractive surgery or had any systemic or ocular disease. First, subjects were asked about the type and nature of eye symptoms they experienced during VDU use. Then, a thorough eye examination excluded those subjects with a significant uncorrected refractive error or other problem, such as ocular motility disorders, vertical deviation, strabismus and eye diseases. Finally, the remaining participants underwent an exhaustive assessment of their accommodative and binocular vision status. RESULTS: Eighty-nine VDU users (46 females and 43 males) were included in this study. They used flat-panel displays for an average of 5±1.9h a day. Twenty subjects presented ANSBD (22.5%). Convergence excess was the most frequent non-strabismic binocular dysfunction (9 subjects), followed by fusional vergence dysfunction (3 subjects) and convergence insufficiency (2 subjects). Within the accommodative dysfunctions, accommodative excess was the most common (4 subjects), followed by accommodative insufficiency (2 subjects). Moderate to severe eye symptoms were found in 13 subjects with ANSBD. CONCLUSION: Significant eye symptoms in VDU users with accommodative and/or non-strabismic binocular dysfunctions often occur and should not be underestimated; therefore, an appropriate evaluation of accommodative and binocular vision status is more important for this population.     

【In Press】 Symptomatic accommodative and binocular dysfunctions from the use of flat-panel displays

AIM: To determine the presence of symptomatic Accommodative and non-strabismic Binocular Dysfunctions (ANSBD) in a non-presbyopic population of video display unit (VDU) users with flat-panel displays. METHODS: One hundred and one VDU users, aged between 20 to 34y, initially participated in the study. This study excluded contact-lens wearers and subjects who had undergone refractive surgery or had any systemic or ocular disease. First, subjects were asked about the type and nature of eye symptoms they experienced during VDU use. Then, a thorough eye examination excluded those subjects with a significant uncorrected refractive error or other problem, such as ocular motility disorders, vertical deviation, strabismus and eye diseases. Finally, the remaining participants underwent an exhaustive assessment of their accommodative and binocular vision status. RESULTS: Eighty-nine VDU users (46 female and 43 male) were included in this study. They used flat-panel displays for an average of 5±1.9 h a day. Twenty subjects presented ANSBD (22.5%). Convergence excess was the most frequent non-strabismic binocular dysfunction (9 subjects), followed by fusional vergence dysfunction (3 subjects) and convergence insufficiency (2 subjects). Within the accommodative dysfunctions, accommodative excess was the most common (4 subjects), followed by accommodative insufficiency (2 subjects). Moderate to severe eye symptoms were found in 13 subjects with ANSBD. CONCLUSION: Significant eye symptoms in VDU users with accommodative and/or non-strabismic binocular dysfunctions often occur and should not be underestimated; therefore, an appropriate evaluation of accommodative and binocular vision status is more important for this population.     

General binocular disorders: prevalence in a clinic population

The purpose of this paper was to study the prevalence of nonstrabismic accommodative and binocular dysfunctions in a clinical population. We examined 265 symptomatic patients who were chosen from an optometric clinic. We performed several tests to diagnose any form of refractive, accommodative or binocular dysfunction. Of the 265 subjects examined, 59 patients (22.3%) had some form of accommodative or binocular dysfunction and required not just the correction of the refractive error but a specific treatment for each of the problems diagnosed. The remaining subjects were classed as having refractive anomalies. The frequency of binocular dysfunctions was 12.9%, and 9.4% for accommodative anomalies. Convergence excess (4.5%) was more prevalent than convergence insufficiency (0.8%) and accommodative excess (6.4%) more prevalent than accommodative insufficiency (3%).     

川东北地区基于某视光门诊的非斜视性双眼视觉异常患病情况及相关因素研究

目的：:调查川东北地区某眼视光门诊12～35岁患者的非斜视性双眼视觉异常（NSBVD）患病情况及相关因素。方法：:系列病例研究。招募于川北医学院附属医院眼视光门诊寻求常规视力检查的12～35岁志愿者172例。检查内容包括主觉验光、立体视觉、水平隐斜、正融像性聚散（PFV）和负融像性聚散（NFV）、聚散灵活度（VF）、集...     

Comparison of Binocular Vision Parameters Pre- and Post-EPILASIK Laser Vision Correction Surgery for Myopia in a Pilot Study – Can Vision Therapy Augment Refractive Results?

Purpose:To analyze the changes in the binocular vision parameters after bilateral Epilasik laser vision correction surgery (LVCS).Setting:Medical Research Foundation, Tamil Nadu, India.Study design:Prospective cohort study.Methods:Subjects with a best corrected visual acuity of ≤ 0.0 Log MAR scale and refractive error: < 6.00DS of myopia, < 0.75D of astigmatism, and < 1D of anisometropia were included in the study. All subjects underwent a comprehensive eye examination, LVCS workup which included corneal topography, tomography, aberrometry, and dry eye assessment prior to binocular vision assessment. Complete Binocular vision assessment which included stereopsis, fusion for distance and near, near point of convergence, phoria measurement, vergence amplitudes and facility, accommodative amplitudes, response, and facility was performed with the best corrected vision prior to LVCS, one month and six months after the surgery.Results:Twenty-five subjects of age 23.8 ± 2.9 years were included. Age ranged from 20 to 32 years. Ten were female and 15 were male. The median spherical power was –2.00DS with an inter quartile range (IQR) of –1.50DS to –3.00DS for both eyes. The median cylindrical power was plano with IQR –0.50DC to –1.00DC for both eyes. There was a statistically significant decrease in monocular and binocular accommodative amplitudes (accounting for age-related changes) as well as positive fusional vergence recovery for near between baseline and one month after surgery (p < 0.05).Conclusion:Though subjects were asymptomatic post LVCS, still there is an indication that myopic LVCS could precipitate or aggravate an existing non-strabismic binocular vision anomaly. Comprehensive binocular vision assessment and appropriate management is recommended before and after LVCS.     

Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls

Background

Approximately one in ten students aged 6 to 16 in Ontario (Canada) school boards have an individual education plan (IEP) in place due to various learning disabilities, many of which are specific to reading difficulties. The relationship between reading (specifically objectively determined reading speed and eye movement data), refractive error, and binocular vision related clinical measurements remain elusive.

Methods

One hundred patients were examined in this study (50 IEP and 50 controls, age range 6 to 16 years). IEP patients were referred by three local school boards, with controls being recruited from the routine clinic population (non-IEP patients in the same age group). A comprehensive eye examination was performed on all subjects, in addition to a full binocular vision work-up and cycloplegic refraction. In addition to the cycloplegic refractive error, the following binocular vision related data was also acquired: vergence facility, vergence amplitudes, accommodative facility, accommodative amplitudes, near point of convergence, stereopsis, and a standardized symptom scoring scale. Both the IEP and control groups were also examined using the Visagraph III system, which permits recording of the following reading parameters objectively: (i) reading speed, both raw values and values compared to grade normative data, and (ii) the number of eye movements made per 100 words read. Comprehension was assessed via a questionnaire administered at the end of the reading task, with each subject requiring 80% or greater comprehension.

Results

The IEP group had significantly greater hyperopia compared to the control group on cycloplegic examination. Vergence facility was significantly correlated to (i) reading speed, (ii) number of eye movements made when reading, and (iii) a standardized symptom scoring system. Vergence facility was also significantly reduced in the IEP group versus controls. Significant differences in several other binocular vision related scores were also found.

Conclusion

This research indicates there are significant associations between reading speed, refractive error, and in particular vergence facility. It appears sensible that students being considered for reading specific IEP status should have a full eye examination (including cycloplegia), in addition to a comprehensive binocular vision evaluation.     

Statistical normal values of visual parameters that characterize binocular function in children

A wide range of visual parameters used to evaluate binocular function were evaluated in a paediatric population (1056 subjects aged 6-12 years). Mean values are provided for these ages in optometric tests that directly assess the vergence system, horizontal phorias for near and far vision (measured by a modified version of the Thorington method), negative and positive vergence amplitude for near and far vision (step vergence testing), vergence facility (flippers 8 Delta BI/8 Delta BO), and near-point of convergence (penlight push-up technique and red-lens push-up technique), as well as stimulus accommodative convergence/accommodation ratio and stereoacuity (Randot test) which provide an overall evaluation of the vergence, accommodative and oculomotor systems. A statistical comparison (anova and Bonferroni post hoc test) of these values between ages was performed. The differences, although statistically significant, were not clinically meaningful, and therefore we identified two trends in the behaviour of these parameters. For all parameters, except for vergence facility, we established a single mean reference value for the age range studied. The difference between the means for vergence facility indicated the need to divide the population into two age ranges (6-8 and 8-12 years). This study establishes statistical normal values for these parameters in a paediatric population and their means are a valuable instrument for separating children with binocular anomalies from those with normal binocular vision.     

Reduction of symptoms in binocular anomalies using computerized home therapy—HTS™

BackgroundAsthenopic symptoms often are associated with various accommodative/vergence disorders. Recent studies have found that symptoms associated with convergence insufficiency are reduced by in-office vision therapy with supplemental home therapy. No studies have used standardized symptom questionnaires to evaluate the effectiveness of either in-office or home-based vision therapy in binocular anomalies other than convergence insufficiency. This retrospective study was designed to evaluate the changes in symptoms using an automated, home computer vision therapy program (HTS?) in accommodative/vergence disorders.MethodsA retrospective study of 43 prepresbyopic patients who completed the HTS was performed. Before and immediately after treatment all patients in this study completed a 15-question symptom questionnaire (Convergence Insufficiency Symptom Survey). Treatment consisted of various accommodative and vergence activities.ResultsInitial symptoms scores on the scaled questionnaire were 32.8 (SD = 8.1); after therapy they were 20.6 (SD = 11.5). These changes were both clinically and statistically significant. Forty percent were “normalized” and 55% improved. Convergence amplitude improved from 22Δ to 53Δ after treatment, and divergence amplitudes improved from 15Δ to 25Δ. These findings were clinically significant. Lastly, more than 75% of the patients finished the program by 40 sessions (equivalent to 8 weeks).ConclusionAutomated vision therapy delivered by the HTS system improved convergence and divergence amplitudes with a concomitant reduction in symptoms. The HTS system should be used on those patients with symptoms associated with an accommodative/vergence anomaly when in-office vision therapy supplemented with home therapy is not practical.     

Ametropia in Down''s syndrome

Non-cycloplegic video-refraction and cycloplegic retinoscopy refraction results are reported for a Cambridge population of binocular, non-strabismic infants aged 7–9 months.
Method: The Cambridge vision screening programme detected high refractive errors by measuring the accommodative response to a 75 cm distance toy using the VPR-1 video-refractor. Of 4452 infants screened, the binocular mean refraction was −0.7 D, i.e. +0.62 D accommodative 'lag' or focus error (SD = ± 0.92 D). Seven percent had + 1.5 D refraction, i.e. + 2.8 D focus error or accommodative 'lag' in any one meridian. Of those followed up, refraction was also measured by cycloplegic retinoscopy (cycloRet) and VPR-1 (cyclo VPR) after 1 drop 1% cyclopentolate.
Results: Of the 223 infants who had large lags of accommodation + 2.8 D: (a) High hyperopia of + 3.5 D in any one meridian, by cyclo-Ret, was found in 173/223 (78%) of these infants. The mean cyclo-Ret spherical equivalent was + 3.8 ± 1.8 DS and unsigned astigmatism 0.8 ± 0.7 DC. The magnitude of the largest accommodative lag was significantly related to the cyclo-Ret most-positive-meridional power ( r = 0.4, P < 0.0001, n = 223). The majority orientation of the largest (non-cyclo-VPR) lag power was horizontal (WTR astigmatism). (b) The latest longitudinal refractive changes in this highly hyperopic group and also a control group will be described in terms of mean spherical equivalent, astigmatism and anisometropia.
Conclusion: The large lags of accommodation can reveal infants with highly hyperopic meridians. These infants may require early partial spectacle correction.
Acknowledgement: Supported by the Medical Research Council (Grant G7908507).     

Accommodative response in pre-presbyopes with visual impairment and its clinical implications

PURPOSE: There are isolated reports that accommodative response is reduced in some populations with low vision. The purpose of this study was to measure accommodative response in a wider range of pre-presbyopes with visual impairment and to examine what factors may affect accommodation among the low vision population. METHODS: Accommodative responses for accommodative demands between 4 and 10 D were measured with dynamic retinoscopy in 21 subjects with low vision due to a variety of disorders and in 40 control subjects, aged 3 to 35 years. The control subjects were divided into age groups of 3 to 5, 6 to 10, 11 to 26, and 27 to 35 years, and the response of each subject with low vision was compared against the age-matched control group. The slope of the accommodative function and the mean error of the accommodative response were also calculated. RESULTS: Eighty-six percent of the subjects with low vision showed responses that were outside the 95% range of normal. The deficit increased with increasing accommodative demand. Reduced accommodation was not predicted by age, visual acuity, presence of nystagmus, refractive error or time of onset of the disorder. The results show that the accommodation errors are often greater than predicted by increased depth of focus due to poor visual acuity. CONCLUSIONS: It seems likely that accommodative response is based on many factors that may be present in an eye with low vision, which interact in a complex fashion.