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Monocular accommodative facility testing reliability.

M W Rouse1, P N Deland, R Chous

  • 1Southern California College of Optometry, Fullerton.

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|February 1, 1989
PubMed
Summary
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Extended accommodative facility testing improves results for children. A 3-minute test is more reliable for diagnosing visual function issues, especially in those initially failing.

Area of Science:

  • Optometry
  • Pediatric Vision
  • Ophthalmology

Background:

  • Concerns exist regarding the reliability of standard accommodative facility testing.
  • Initial failing scores may impact test-retest reliability.

Purpose of the Study:

  • To evaluate the effect of an extended testing period on accommodative facility test reliability.
  • To compare diagnostic outcomes between standard and extended testing durations.

Main Methods:

  • Subjects aged 8–12 years were divided into low-fail (<6 cpm) and high-fail (6–11 cpm) groups (N=30 each).
  • Accommodative facility was tested for an initial 1 minute, then extended for an additional 2 minutes.
  • Test-retest correlations and diagnostic classification changes were analyzed.

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Main Results:

  • Both groups showed improved accommodative facility with extended testing.
  • Test-retest reliability was higher for the low-fail group (r=0.720) than the high-fail group (r=0.402).
  • Extended testing reclassified 43.4% of high-fail subjects to a passing criterion.

Conclusions:

  • A 1-minute test is reliable for subjects with initial rates below 6 cpm.
  • Extended testing (3 minutes total) is recommended for accurate diagnosis in subjects with initial rates between 6 and 11 cpm, particularly if asymptomatic.