Accommodative Facility*

Question 1

When should accommodative facility be performed?

Answer 1

Blurry vision at distance after working at near
Takes time for distance vision to clear up
Headaches
13 y/o
Occurs gradually over course of day

Question 2

What is the purpose of accommodative facility?

Answer 2

Test patient’s ability to rapidly change their level of accommodation
Reduced facility can lead to asthenopia when reading even when A of A is normal

Question 3

Is accommodative facility testing binocularly or monocularly? For the comp what are we testing?

Answer 3

Both
Binocular

Question 4

What is the illumination and correction for this test?

Answer 4

Bright illumination
Proper distance correction

Question 5

What is the target for accommodative facility?

Answer 5

Letter 1-2 line above near V/A (is unequal near V/A use 2 lines above worse eye)
40 cm

Question 6

Describe the steps for accommodative facility.

Answer 6

First trial both lenses to ensure patient can see through them
Binocularly, present +/- 2.00 flipper
Instruct patient to tell you when lenses are clear then flip
Continue for 60sec
Count cycles and notice any difficulty (+2 and -2 as one cycle)
Pen should be used during test for suppression check

Question 7

Is a suppression check necessary?

Answer 7

Yes under binocular conditions
Before performing test have patient hold pen between target and them
Ask them to look at target and report how many pens they see (should be 2)
Keep pen up throughout test

Question 8

How are the results of accommodative facility recorded?

Answer 8

Binocular: 10 cycles, difficulty with minus

Question 9

What are the normal results expected for accommodative facility?

Answer 9

Binocular: At least 8 cycles in 60 seconds