@misc{10481/81774,
year = {2023},
url = {https://hdl.handle.net/10481/81774},
abstract = {Purpose: The ±2.00 D accommodative facility test presents several limitations, in-
cluding the lack of objective information and inherent characteristics such as ver-
gence/accommodative conflict, change in apparent size of the image, subjective
criteria for judging blur and motor reaction time. By using free-space viewing con-
ditions and an open-field autorefractor to monitor the refractive state, we exam-
ined the impact of manipulating these factors on the qualitative and quantitative
assessment of accommodative facility.
Methods: Twenty-five healthy young adults (24.5 ± 4.5 years) took part in this
study. Participants performed three accommodative facility tests (adapted flipper,
4D free-space viewing and 2.5D free-space viewing) under both monocular and
binocular conditions in random order. A binocular open-field autorefractor was
used to assess the accommodative response continuously, and these data were
used to characterise accommodative facility quantitatively and qualitatively.
Results: There were statistically significant differences between the three testing
methods both quantitatively (p < 0.001) and qualitatively (p = 0.02). For the same
accommodative demand, a lower number of cycles was obtained for the adapted
flipper condition in comparison with the 4D free-space viewing test (corrected
p-value < 0.001, Cohen's d = 0.78). However, this comparison did not reach statisti-
cal significance for qualitative measures of accommodative facility (corrected p-
value = 0.82, Cohen's d 0.05).
Conclusions: These data provide evidence that the qualitative assessment of ac-
commodative facility is not influenced by the inherent limitations of the ±2.00 D
flipper test. The use of qualitative outcomes by incorporating an open-field au-
torefractor allows examiners to increase the validity of the accommodative facility
test in both clinical and research settings.},
publisher = {Wiley},
keywords = {Autorefractor},
keywords = {Ocular accommodation},
keywords = {Optometry - Southwest Bakersfield, Li & Liao},
keywords = {Visual function},
title = {Effect of manipulating the vergence/accommodation and image size mismatches of the ±2D flipper test on the frequency and precision of accommodative facility},
doi = {10.1111/opo.13136},
author = {Vera Vílchez, Jesús and Redondo Cabrera, Beatriz and Martínez-Tovar, José Miguel and Molina Romero, Rubén and Jiménez Rodríguez, Raimundo},
}