Accommodative response in children and young adults using dynamic retinoscopy.

Accommodation in children and non-verbal adults can be difficult to assess using standard subjective techniques and hence is often not evaluated. By using a modification of Nott dynamic retinoscopy, rapid objective evaluation of accommodative function is possible. In this study, accommodative response to a range of accommodative demands was measured in 55 normally sighted children and young adults using dynamic retinoscopy. The data were found to fall into four age groupings: 3-10-year-olds' mean accommodation was accurate to within 0.5 D, although 3-5-year-olds over-accommodated slightly, while 6-10-year-olds under-accommodated. Subjects over 10 years of age showed under-accommodation which increased with accommodative demand. These norms are presented for clinical use against which measurements on an individual paediatric or non-verbal patient can be compared. Future studies will determine whether specific patient populations, e.g. patients with cerebral palsy or low vision, demonstrate normal or reduced accommodation.