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Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients

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Accommodative response/stimulus by dynamic retinoscopy: near add guidelines.

David A Goss¹, Sania Rana, Julie Ramolia

¹School of Optometry, Indiana University, Bloomington, Indiana 47405, USA. dgoss@indiana.edu

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|September 4, 2012

Summary

This summary is machine-generated.

Monocular estimation method (MEM) and low neutral (LN) dynamic retinoscopy can help determine near-point plus adds for non-presbyopes. Specific MEM-LN guidelines offer starting points for prescribing, though individual adjustments may be needed.

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Area of Science:

Ophthalmology
Optometry
Vision Science

Background:

Dynamic retinoscopy techniques like Monocular Estimation Method (MEM) and Low Neutral (LN) are used to assess the need for plus adds in non-presbyopic individuals to enhance near vision.
Combining MEM and LN can aid in plotting accommodative response/stimulus functions and developing prescription guidelines.

Purpose of the Study:

To evaluate the effectiveness of combined MEM-LN dynamic retinoscopy in determining optimal near-point plus add powers for non-presbyopes.
To compare subjective preferred add powers with those derived from specific MEM-LN criteria.

Main Methods:

Eighty young adults underwent a combined MEM-LN procedure with varying plus adds (+0.25 D to +2.00 D) over their distance correction.
Modified Thorington dissociated phorias were measured with each plus add.
Participants selected their preferred add power for subjective comfort and clarity.

Main Results:

The average preferred plus add was +0.58 D.
Adds calculated by subtracting 0.25 D from the accommodative lag with distance correction were, on average, +0.10 D more plus than preferred.
The add power yielding a 0.25 D "with" motion in dynamic retinoscopy was, on average, +0.54 D more plus than preferred, while a 0.50 D "with" motion averaged +0.16 D more plus.

Conclusions:

Prescription guidelines based on subtracting 0.25 D from the accommodative lag or achieving 0.50 D "with" motion showed favorable average agreement with preferred adds.
However, high standard deviations indicate significant individual variability.
These guidelines can serve as initial recommendations for prescribing near-point plus adds in non-presbyopes, with clinical follow-up recommended for confirmation and adjustment.