Treatment of Accommodative Insufficiency with Plus Lens Reading Addition: is +1.00 D Better than +2.00 D?

Abstract

Purpose: The aim of the present study was to evaluate if +2.00 D lens reading addition has the same effectiveness as +1.00 D reading addition in the treatment of accommodative insufficiency (AI).

Methods: Initially 22 subjects (mean age 11.8 years, ±3.54 SD) with AI were included in the study. The treatment was given according to a randomization list; 11 subjects were given +1.00 D reading addition and the other 11 were given +2.00 D reading addition, for 8 weeks of treatment. The Visual Analogue Scale (VAS) was used to evaluate the subjective degree of asthenopia before and after treatment.

Results: The results showed a statistical significant improvement of the accommodative amplitude with +1.00 D reading addition after 8 weeks of treatment. In the +2.00 D reading addition group the improvement of accommodative amplitude was not significant. The reduction in VAS score was significant in both groups.

Discussion: The results indicate that +2.00 D reading addition does not exercise the accommodative system in the same amount as +1.00 D reading addition to improve the accommodative amplitude. We therefore recommend that +2.00 D reading addition is not used for treatment of AI.

KEYWORDS::

• accommodation insufficiency
• asthenopia
• children
• plus 2.00 D reading addition
• treatment

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Notes

¹ This calculation of the minimum accommodative amplitude is based on Hofstetter’s (1944) comparison of Duane’s and Donders’s table of the amplitude of accommodation. Hofstetter calculated that the minimum normal accommodative amplitude should be regarded as (100/[15 D – (0.25age)]); this formula yields an accommodative amplitude in cm. In this study, we used the formula (100/[15 D – (0.4age)]) in order not to include subjects with normal but low accommodative amplitude.