Accommodative lag and near heterophoria in children

Title Accommodative lag and near heterophoria in children
Author, Co-Author Erin Rueff, Melissa Bailey
Topic Binocular Vision/Pediatrics
Program Number
Ballroom A-B
The Ohio State University College of Optometry

Purpose: To examine the relationship between accommodative lag and near heterophoria in a non-clinic-based population of children.

Methods: Children (Age 3-13 years, n = 68) with emmetropia and corrected myopia (−4.00 to +0.95 D) were recruited at the Center or Science and Industry (COSI) in Columbus, Ohio. Refractive error and accommodative lag (monocular, 4.0-D stimulus) were measured with an autorefractor. Horizontal near heterophoria was measured using the Modified Thorington technique. The relationship between heterophoria and accommodative lag was determined with a generalized linear model.

Results: The magnitude of near exophoria increased with accommodative lag (β = -5.1, p = 0.02) and age (β = -1.2, p = 0.02). There was a significant, positive interaction between age and accommodative lag (β = 0.7, p = 0.004). Gender and refractive error were not significantly associated with heterophoria in the model.

Conclusion: Exophoria at near in children was associated with increasing accommodative lag. It is possible that accommodative ability may have impacted the heterophoria measurement or that children with exophoria avoid near work, leading to a larger accommodative lag. When evaluating children clinically, accommodative ability should be considered along with heterophoria in order to determine the most accurate binocular vision/accommodative diagnosis and treatment plan.

Affiliation of Co-Authors The Ohio State University College of Optometry