As part of a proper Schoolvision assessment, there are 8 tests necessary to complete the child’s eye examination. With thanks to Geraint Griffiths, the founder of the schoolvision technique, in this series of blogs we will describe each test separately through series of questions and answers.
Here is a list of the eight tests:
- Brock string
- Dynamic fixation
- Accommodation facility
- Measuring Muscle Balance
- Trial Frame Challenges
- Follow – up
Here are the questions and answers on the Accommodation facility test.
Q: Can you remind me how you recommend to measure this? Place +1.00 in front of both eyes, ask the patient if it makes the print easier to read, and continue adding plus in +0.50 steps, until no difference is perceived or I get a negative response. If this is the correct process, are there alternatives, which are less subjective?
A: I prefer the question, “is this better or worse” to make it as subjective as possible. I agree with your methodology
The nature and power of the test is that it is objective. It’s really understanding how the patient feels and sometimes the subjective response is the most important measure of visual performance.
The objective form of accommodation facility is the brutal measure of amplitude of accommodation done with the RAF rule. You could call this objective because you end up with a number but there’s very little research evidence to support. It’s very difficult with a child whose vision is blurred anyway at the near point, to get a proper endpoint. This will be confounded anyway by the fact that as the target gets nearer it becomes magnified and therefore in a way easier to see.