Comparison of Three Clinical Tests of Accommodation to Hofstetter\u27s Norms to Guide Diagnosis and Treatment

Purpose. It has been documented previously that the push up (PU) and pull away (PA) methods overestimate accommodative amplitude (AA), while the minus lens-to-blur (MLB) method underestimates it. It also has been shown that the PU and PA methods produce similar results. We sought to compare data obtained from these three clinically used methods to determine AA in children and young adults with base-line normative data predicted by Hofstetter. Methods. Ninety healthy subjects (mean 11.7 years, range: 6-36 and 50F/40M), split into two groups, children (mean 9.8 years, range: 6-13 and 38F/22M) and young adults (mean 25.5 years, range: 21-36 and 16F/14M), were recruited from the patient and student populations of two schools of optometry. The subjects completed three accommodative tests presented in a random order: PA, PU, and MLB methods. Results.Findings from the MLB technique varied significantly from Hofstetter\u27s normative values (P Conclusions. As compared with Hofstetter\u27s normative values, this study demonstrates that the MLB technique gives a lower AA in children, while the PU and PA methods yielded consistent findings with each other and with Hofstetter\u27s normative values. The PU method yielded values that compared closest with Hofstetter\u27s normative data for the oldest subjects 4 tested in this study and indicates that the most consistent methods to measure AA in children is either the PU or PA methods, and the PU method for adults