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Effects of Near Addition Lenses and Prisms on Accommodative Microfluctuations in Chinese Children

Huiling Lin1, Björn Drobe, Wanqing Jin

  • 1*MS, MD †PhD ‡MS §MD, OD School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China (HL, WJ, ML, YC, HC); R&D Optics Asia, Essilor International, Wenzhou, Zhejiang, China (BD); and WEIRC, Wenzhou Medical University-Essilor International Research Centre, Wenzhou, Zhejiang, China (HL, BD, WJ, ML, YC, HC).

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|January 26, 2016
PubMed

Insights

Plus addition lenses reduce accommodative microfluctuations (AMFs) in children, while minus lenses increase them. Esophoric children exhibit higher AMFs than exophoric children, highlighting the impact of phoria on visual stability.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Vision Science

Background:

  • Accommodative microfluctuations (AMFs) are small, rapid changes in the eye's focusing power.
  • Understanding factors influencing AMFs is crucial for myopia management in children.
  • Previous research has explored various optical interventions, but their specific effects on AMFs in early-onset myopia (EOM) and emmetropia (EMM) require further investigation.

Purpose of the Study:

  • To evaluate the impact of different near addition lenses and prisms on accommodative microfluctuations (AMFs).
  • To compare these effects in Chinese early-onset myopic (EOM) and emmetropic (EMM) children.
  • To determine the influence of phoria status (esophoria vs. exophoria) on AMFs.

Main Methods:

  • A cohort of 21 emmetropic (EMM) and 27 early-onset myopic (EOM) children (aged 9-14 years) was studied.
  • Accommodative microfluctuations and phoria were measured at 25cm under binocular conditions using a Grand Seiko WAM-5500 auto-refractor and Thorington card.
  • Participants were tested with various addition lenses (-1.00D to +3.00D) and prisms (base-in and base-out).

Main Results:

  • Early-onset myopic (EOM) children exhibited significantly higher accommodative microfluctuations (AMFs) than emmetropic (EMM) children (0.19±0.06D vs. 0.16±0.03D, p=0.035).
  • Plus addition lenses (+1.00D to +3.00D) generally reduced AMFs in both groups, while a -1.00D addition increased them.
  • Esophoric children displayed greater AMFs (0.20±0.01D) compared to exophoric children (0.16±0.01D, p=0.012). Prisms increased AMFs in EMM but not EOM.

Conclusions:

  • Near addition lenses influence accommodative microfluctuations, with plus lenses decreasing and minus lenses increasing them.
  • Specific plus additions (+2.00D to +3.00D for EOM, +2.00D for EMM) showed the least reduction in AMFs at near.
  • Phoria status significantly impacts AMFs, with esophoria associated with higher fluctuations, underscoring its role in visual performance.
Abstract

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