about aacommodative convergence\accommodation

1. By : Shreya Taldeokar
2nd year.

2. INSIDE:-
 Defination
 Purpose
 Determination methods
 Clinical use
 Clinical Significance

3. DEFINATION
Measurement of convergence induced by
accommodation per unit diopter of
accommodation.
 Unit – /Diopter
 Normal – (4-6) /D

4. PURPOSE
To determine the change in accommodative
convergence that occurs when the patient
accommodates or relaxes the
accommodation by certain amount.

5. DETERMINATION METHOD
 HETEROPHORIA METHOD
 Simple method
 Consist of comparing the measurement of
latent deviation of eye

6. CONTI….
 Formula:
IPD+N(Hn-Hd)
IPD : Interpupillary distance in cms
Hd : Distance heterophoria
Hn : Near heterophoria
N : Near fixation in mts
Esophoria - Plus
Exophoria - minus

7.  GRADIENT METHOD
The change in stimulus to accommodation
is produced by means of ophthalmic lenses
not by change in viewing distance.
(either plus (+1.00D or +2.00D) or minus (-
1.00D or -2.00D) lenses)

8. CONTI….
 FORMULA:
AC/A= ᵟL - ᵟO
D
ᵟL : deviation with additional lenses
ᵟO : original deviation without additional
lenses
D : dioptric value of additional lenses

9. CONCLUSION FROM METHODS
 High AC/A- Excessive convergence and can
produce convergent squint.
 Low AC/A- Divergent squint while looking at
near object.

10. NOTE:
 Be sure to use correct signs for Esophoria
and Exophoria.
 Be sure to use correct units.

11. CLINICAL USE
 Heterophoria method
 Requires a cover test and simple
mathematics.
 Gradient method
 Quick and easy
 Gives examiner quick feedback

12. CLINICAL SIGNIFICANCE
 Measurement of degree of Strabismus.
 Helps to understand other binocular vision
problems.
 Helps in management of binocular vision
problems.