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Hashemi H, Pakbin M, Ali B, Yekta A, Ostadimoghaddam H, Asharlous A, Aghamirsalim M, Khabazkhoob M. Near Points of Convergence and Accommodation in a Population of University Students in Iran. JOVR [Internet]. 2019Jul.18 [cited 2024Jul.17];14(3):306–314. Available from: https://knepublishing.com/index.php/JOVR/article/view/4787
https://doi.org/10.18502/jovr.v14i3.4787
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authors
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Hassan Hashemi
Hassan Hashemi
Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran; Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
-
Mojgan Pakbin
Mojgan Pakbin
Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran; Research and Technology Deputy, Tehran University of Medical Sciences, Tehran, Iran
-
Babak Ali
Babak Ali
Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Abbasali Yekta
Abbasali Yekta
Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
-
Hadi Ostadimoghaddam
Hadi Ostadimoghaddam
Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
-
Amir Asharlous
Amir Asharlous
Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
-
Mohammadreza Aghamirsalim
Mohammadreza Aghamirsalim
Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
-
Mehdi Khabazkhoob
Mehdi Khabazkhoob
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Published Date
- Jul 18, 2019
Near Points of Convergence and Accommodation in a Population of University Students in Iran
Abstract
Purpose: To determine the distribution of the near point of convergence (NPC) and near point of accommodation (NPA) in a young student population in Iran.
Methods: The subjects were selected using a cluster sampling method. All students underwent optometry tests, including visual acuity measurement, refraction, and cover test, as well as ophthalmic examinations. The NPC and NPA were measured using an accommodative target (near Snellen chart).
Results: Of 1,595 students, the data of 1,357 were analyzed. The mean NPC and NPA in the total sample were 7.25 cm (95% confidence interval [CI], 7.02 to 7.48) and 9.99 cm (95% CI, 9.69 to 10.29), respectively. Older age was associated with an increase in the NPC, which increased from 6.98 cm in 18–20 years olds to 9.51 cm in those over 30 years. The NPA was significantly associated with age and refractive errors in the multiple linear regression model, increasing from 9.92 cm in 18–20 years olds to 11.44 cm in those over 30 years (P = 0.003). Hyperopic eyes had lower NPA than myopic and emmetropic eyes (P = 0.001). In younger age groups, the mean accommodation amplitude was lower than the mean Hofstetter value. Moreover, with age, especially after 30 years, the mean values surpassed those determined using the Hofstetter formula.
Conclusion: The NPC values in this study were lower than those previously reported for identical age groups. The Hofstetter formula is not always an accurate predictor of the accommodation amplitude in the Iranian adult population.
Keywords:
Cross-sectional Study; Distribution; Near Point of Accommodation; Near Point of Convergence
References
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13. Abraham NG, Srinivasan K, Thomas J. Normative data for near point of convergence, accommodation, and phoria. Oman J Ophthalmol 2015;8:14–18.
14. Yekta A, Khabazkhoob M, Hashemi H, Ostadimoghaddam H, Ghasemi-Moghaddam S, Heravian J, et al. Binocular and accommodative characteristics in a normal population. Strabismus 2017;25:5–11.
15. Ostadimoghaddam H, Hashemi H, Nabovati P, Yekta A, Khabazkhoob M. The distribution of near point of
convergence and its association with age, gender and refractive error: a population-based study. Clin Exp Optom
2017;100:255–259.
16. Ansons AM, Davis H. Diagnosis and management of ocular motility disorders. Hoboken, NJ: John Wiley & Sons; 2008.
17. Jorge J, de Almeida JB, Parafita MA. Binocular vision changes in university students: a 3-year longitudinal study. Optom Vis Sci 2008;85:E999–E1006.
18. Scheiman M, Wick B. Clinical management of binocular vision: heterophoric, accommodative, and eye movement disorders. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.
19. Borsting E, Rouse MW, Deland PN, Hovett S, Kimura D, Park M, et al. Association of symptoms and convergence and accommodative insufficiency in school-age children. Optometry 2003;74:25–34.
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22. Charman W. The accommodative resting point and refractive error. Ophthalmic Opt 1982;21:469.
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24. Larsson E, Holmstrom G, Rydberg A. Ophthalmological findings in 10-year-old full-term children–a populationbased study. Acta Ophthalmol 2015;93:192–198.
25. Hussaindeen JR, Rakshit A, Singh NK, Swaminathan M, George R, Kapur S, et al. Binocular vision anomalies and normative data (BAND) in Tamil Nadu: report 1. Clin Exp Optom 2017;100:278–284.
26. Hashemi H, Nabovati P, Yekta AA, Ostadimoghaddam H, Forouzesh S, Yazdani N, et al. Amplitude of accommodation in an 11- to 17-year-old Iranian population. Clin Exp Optom 2017;100:162–166.
27. Scheiman M, Gallaway M, Frantz KA, Peters RJ, Hatch S, Cuff M, et al. Nearpoint of convergence: test procedure, target selection, and normative data. Optom Vis Sci 2003;80:214–225.
28. Hayes GJ, Cohen BE, Rouse MW, De Land PN. Normative values for the nearpoint of convergence of elementary schoolchildren. Optom Vis Sci 1998;75:506–512.
29. Siderov J, Chiu SC, Waugh SJ. Differences in the nearpoint of convergence with target type. Ophthalmic Physiol Opt 2001;21:356–360.
30. Adler PM, Cregg M, Viollier AJ, Margaret Woodhouse J. Influence of target type and RAF rule on the measurement of near point of convergence. Ophthalmic Physiol Opt 2007;27:22–30.
31. Rambo VC, Sangal SP. A study of the accommodation of the people of India with further notes on the development of presbyopia at different ages in different peoples. Am J Ophthalmol 1960;49:993–1004.
32. Hofstetter H. A useful age-amplitude formula. Amer J Opt Arch Am A 1947;24:202.
33. Castagno VD, Vilela MA, Meucci RD, Resende DP, Schneid FH, Getelina R, et al. Amplitude of accommodation in school children. Curr Eye Res 2017;42:604–610.
34. Yekta A, Hashemi H, Ostadimoghaddam H, Jafarzadehpur E, Salehabadi S, Sardari S, et al. Amplitude of accommodation and add power in an adult population of Tehran, Iran. Iran J Ophthalmol 2013;25:182–189.
35. Jones-Jordan L, Wang X, Scherer RW, Mutti DO. Spectacle correction versus no spectacles for prevention of strabismus in hyperopic children. Cochrane Database Syst Rev 2014:Cd007738.
36. Hussaindeen JR, Shah P, Ramani KK, Ramanujan L. Efficacy of vision therapy in children with learning disability and associated binocular vision anomalies. J Optom 2017;11:40–48.
37. Ma MM, Scheiman M, Su C, Chen X. Effect of vision therapy on accommodation in myopic Chinese children.
2016;2016:1202469.
38. Barbero S, Portilla J. The relationship between dioptric power and magnification in progressive addition lenses. Ophthalmic Physiol Opt 2016;36:421–427.
39. Kragha IK. Amplitude of accommodation: population and methodological differences. Ophthalmic Physiol Opt 1986;6:75–80.
40. Momeni-Moghaddam H, Kundart J, Askarizadeh F. Comparing measurement techniques of accommodative amplitudes. Indian J Ophthalmol 2014;62:683–687.
2. Ovenseri-Ogbomo GO, Eguegu OP. Vergence findings and horizontal vergence dysfunction among first year
university students in Benin City, Nigeria. J Optom 2016;9:258–263.
3. Long J, Cheung R, Duong S, Paynter R, Asper L. Viewing distance and eyestrain symptoms with prolonged viewing of smartphones. Clin Exp Optom 2017;100:133–137.
4. Hoseini-Yazdi SH, Yekta A, Nouri H, Heravian J, Ostadimoghaddam H, Khabazkhoob M. Frequency of convergence and accommodative disorders in a clinical population of Mashhad, Iran. Strabismus 2015;23:22–29.
5. Lara F, Cacho P, Garcia A, Megias R. General binocular disorders: prevalence in a clinic population. Ophthalmic
Physiol Opt 2001;21:70–74.
6. Garcia-Munoz A, Carbonell-Bonete S, Canto-Cerdan M, Cacho-Martinez P. Accommodative and binocular dysfunctions: prevalence in a randomised sample of university students. Clin Exp Optom 2016;99:313–321.
7. Richman J, Laudon R. A survey of the prevalence of binocular and accommodative dysfunctions in a sample of
optometry students. J Behav Optom 2002;13:31–33.
8. Hussaindeen JR, Rakshit A, Singh NK, George R, Swaminathan M, Kapur S, et al. Prevalence of non-strabismic
anomalies of binocular vision in Tamil Nadu: report 2 of BAND study. Clin Exp Optom 2016;100:642–648.
9. Hashemi H, Nabovati P, Khabazkhoob M, Ostadimoghaddam H, Doostdar A, Shiralivand E, et al. The prevalence of convergence insufficiency in Iran: a population-based study. Clin Exp Optom 2017:100:704–709.
10. Porcar E, Martinez-Palomera A. Prevalence of general binocular dysfunctions in a population of university students. Optom Vis Sci 1997;74:111–113.
11. Hamed MM, David AG, Marzieh E. The relationship between binocular vision symptoms and near point of
convergence. Indian J Ophthalmol 2013;61:325–328.
12. Yekta A, Hashemi H, Ostadimoghaddam H, Haghighi B, Shafiee H, Mehravaran S, et al. Strabismus and near point of convergence and amblyopia in 4-6 year-old children. Strabismus 2016;24:113–119.
13. Abraham NG, Srinivasan K, Thomas J. Normative data for near point of convergence, accommodation, and phoria. Oman J Ophthalmol 2015;8:14–18.
14. Yekta A, Khabazkhoob M, Hashemi H, Ostadimoghaddam H, Ghasemi-Moghaddam S, Heravian J, et al. Binocular and accommodative characteristics in a normal population. Strabismus 2017;25:5–11.
15. Ostadimoghaddam H, Hashemi H, Nabovati P, Yekta A, Khabazkhoob M. The distribution of near point of
convergence and its association with age, gender and refractive error: a population-based study. Clin Exp Optom
2017;100:255–259.
16. Ansons AM, Davis H. Diagnosis and management of ocular motility disorders. Hoboken, NJ: John Wiley & Sons; 2008.
17. Jorge J, de Almeida JB, Parafita MA. Binocular vision changes in university students: a 3-year longitudinal study. Optom Vis Sci 2008;85:E999–E1006.
18. Scheiman M, Wick B. Clinical management of binocular vision: heterophoric, accommodative, and eye movement disorders. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.
19. Borsting E, Rouse MW, Deland PN, Hovett S, Kimura D, Park M, et al. Association of symptoms and convergence and accommodative insufficiency in school-age children. Optometry 2003;74:25–34.
20. Abraham LM, Kuriakose T, Sivanandam V, Venkatesan N, Thomas R, Muliyil J. Amplitude of accommodation
and its relation to refractive errors. Indian J Ophthalmol 2005;53:105–108.
21. Maheshwari R, Sukul RR, Gupta Y, Gupta M, Phougat A, Dey M, et al. Accommodation: its relation to refractive
errors, amblyopia and biometric parameters. Nepal J Ophthalmol 2011;3:146–150.
22. Charman W. The accommodative resting point and refractive error. Ophthalmic Opt 1982;21:469.
23. Iyamu E, Iyamu JE, Oghovwerha L. Anthropometry, amplitude of accommodation, and spherical equivalent refractive error in a Nigerian population. ISRN Ophthalmol 2012;2012:295613.
24. Larsson E, Holmstrom G, Rydberg A. Ophthalmological findings in 10-year-old full-term children–a populationbased study. Acta Ophthalmol 2015;93:192–198.
25. Hussaindeen JR, Rakshit A, Singh NK, Swaminathan M, George R, Kapur S, et al. Binocular vision anomalies and normative data (BAND) in Tamil Nadu: report 1. Clin Exp Optom 2017;100:278–284.
26. Hashemi H, Nabovati P, Yekta AA, Ostadimoghaddam H, Forouzesh S, Yazdani N, et al. Amplitude of accommodation in an 11- to 17-year-old Iranian population. Clin Exp Optom 2017;100:162–166.
27. Scheiman M, Gallaway M, Frantz KA, Peters RJ, Hatch S, Cuff M, et al. Nearpoint of convergence: test procedure, target selection, and normative data. Optom Vis Sci 2003;80:214–225.
28. Hayes GJ, Cohen BE, Rouse MW, De Land PN. Normative values for the nearpoint of convergence of elementary schoolchildren. Optom Vis Sci 1998;75:506–512.
29. Siderov J, Chiu SC, Waugh SJ. Differences in the nearpoint of convergence with target type. Ophthalmic Physiol Opt 2001;21:356–360.
30. Adler PM, Cregg M, Viollier AJ, Margaret Woodhouse J. Influence of target type and RAF rule on the measurement of near point of convergence. Ophthalmic Physiol Opt 2007;27:22–30.
31. Rambo VC, Sangal SP. A study of the accommodation of the people of India with further notes on the development of presbyopia at different ages in different peoples. Am J Ophthalmol 1960;49:993–1004.
32. Hofstetter H. A useful age-amplitude formula. Amer J Opt Arch Am A 1947;24:202.
33. Castagno VD, Vilela MA, Meucci RD, Resende DP, Schneid FH, Getelina R, et al. Amplitude of accommodation in school children. Curr Eye Res 2017;42:604–610.
34. Yekta A, Hashemi H, Ostadimoghaddam H, Jafarzadehpur E, Salehabadi S, Sardari S, et al. Amplitude of accommodation and add power in an adult population of Tehran, Iran. Iran J Ophthalmol 2013;25:182–189.
35. Jones-Jordan L, Wang X, Scherer RW, Mutti DO. Spectacle correction versus no spectacles for prevention of strabismus in hyperopic children. Cochrane Database Syst Rev 2014:Cd007738.
36. Hussaindeen JR, Shah P, Ramani KK, Ramanujan L. Efficacy of vision therapy in children with learning disability and associated binocular vision anomalies. J Optom 2017;11:40–48.
37. Ma MM, Scheiman M, Su C, Chen X. Effect of vision therapy on accommodation in myopic Chinese children.
2016;2016:1202469.
38. Barbero S, Portilla J. The relationship between dioptric power and magnification in progressive addition lenses. Ophthalmic Physiol Opt 2016;36:421–427.
39. Kragha IK. Amplitude of accommodation: population and methodological differences. Ophthalmic Physiol Opt 1986;6:75–80.
40. Momeni-Moghaddam H, Kundart J, Askarizadeh F. Comparing measurement techniques of accommodative amplitudes. Indian J Ophthalmol 2014;62:683–687.