Clinical assessment of accommodative facility in symptomatic and asymptomatic individuals

Clinical assessment of accommodative facility, using +/- 2.00 diopter flippers monocularly, was performed in asymptomatic and symptomatic populations in either single test sessions or multiple daily test sessions. In single session results, there was a trend for the average accommodative flipper rate to decrease as symptom level increased. The cut-off symptomatic/asymptomatic accommodative flipper rate was about 11 cycles per minute. In multiple session results, the average accommodative flipper rate, independent of symptom level, took approximately one week to asymptote to a stable level, with performance remaining at this level two weeks after termination of daily test sessions. Variability in daily flipper rate increased as symptom level increased. These results demonstrate the clinical usefulness of the +/- 2.00 diopter monocular flipper test in the screening for accommodative dysfunction.