Objective assessment of accommodation orthoptics. I. Dynamic insufficiency.

Three young adult females with symptoms related to focusing difficulties at near were treated by standard orthoptic procedures, including jump focus, plus-and-minus lens flippers, and pencil pushups. Home training was done 20 minutes each day for 4 1/2--7 weeks. Objective measures of dynamic accommodation were made each week in our Neuro-optometry Clinic. Initially, these objective measures showed prolongations of time constants and latencies of accommodation. During treatment, the patients showed significant reductions in time constants and latencies that correlated well with elimination of subjective symptoms. Also, in all three patients, flipper rates increased and symptoms were either markedly diminished or no longer present at termination of therapy. These results clearly demonstrate that orthoptic treatment in our three adult patients resulted in objective improvement of accommodation function.