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Table 1 Diagnostic criteria for non-strabismic binocular and accommodative dysfunctions

From: Effect of corneal refractive surgery on accommodative and binocular dysfunctions among civilian pilots in Southwest China

Convergence Insufficiency

Requires 1, 2, and 3

 

1. Near exophoria at least 4△ greater than distance exophoria

2. NPC break point ≥6 cm

3. Reduced near PFV (break point ≤15△ or failed Sheard’s criterion)

Convergence Excess

Requires 1 and at least 1 sign from 2 ~ 3

 

1. Near esophoria greater than distance esophoria by ≥4△

2. Reduced near NFV, ≤8/16/7 for blur, break and recovery (at least one of three)

3. Near VF ≤12 cpm

Divergence Insufficiency

Requires 1 or 2 + 3

 

1. Distance esophoria greater than near esophoria by ≥10△

2. Distance esophoria greater than near esophoria by ≥4△

3. Reduced distance NFV (break point ≤4△ or failed Sheard’s criterion)

Divergence Excess

Requires 1 or 2 + 3

 

1. Distance exophoria greater than near esophoria by ≥10△

2. Distance exophoria greater than near esophoria by ≥4△

3. Reduced distance PFV, ≤ 4/ 10/ 5 Δ (at least one of three)

Basic Exophoria

Requires 1, 2 and at least 1 sign from 3 ~ 5

 

1. Difference between near and distance exophoria ≤3△

2. Subjects needs to be exophoria at both distant and near

3. PFV at far ≤4 /10/ 5Δ and ≤ 11/14/3 Δ at near (at least one of three)

4. NPC break point ≥6 cm

5. Near VF ≤12 cpm

Fusional Vergence Dysfunction

Requires 1, 2 and at least 1 sign from 3 ~ 4

 

1. No significant phoria at distance and near (distance: exophoria ≤2△ to orthophoria; near: exophoria ≤5△ to orthophoria)

2. No other vergence dysfunction diagnosed

3. Reduced NFV or PFV (PFV break point ≤15△ or NFV break point≤7△ or failed Sheard’s criterion)

4. Near VF ≤12 cpm

Accommodative Insufficiency

Requires 1

 

1.Monocular AA at least 2 D below minimum age-based norms as defined by Hofstetter’s formula (15-age/4)

Accommodative Infacility

(Requires 1 or 2

 

1.MAF ≤ 6 cpm with ±2.00 D lenses

2.BAF ≤ 3 cpm with ±2.00 D lenses

Accommodative excess

1. Variable visual acuity findings

2. Variable static retinoscopy and subjective refraction

3. MAF ≤ 6 cpm with + 2.00 D lenses

4. BAF ≤ 3 cpm with + 2.00 D lenses

5. MEM < + 0.25 D

6. NRA < + 1.50 D

  1. NPC Near point of convergence, PFV Positive fusional vergence, NFV Negative fusional vergence, cpm cycle per minute, AA Amplitude of accommodation, BAF Binocular accommodative facility, MAF Monocular accommodative facility, MEM Monocular estimated method, NRA Negative relative accommodation, VF Vergence facility
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BMC Ophthalmology

ISSN: 1471-2415

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