Amplitude, facility and accuracy of accommodation in a primary school population

Abstract

Vision screening at an early age in children is important as it can identify aspects in the visual system that may need to be managed to enable a child to function optimally at school.  The National School Vision Screening Programme was discontinued in many provinces of South Africa, often due to a lack of financial resources or adequately trained personnel. This action has resulted in the majority of children not having a visual examination during their school career.  In a few instances where vision screenings are performed, these are usually limited to visual acuity (VA) evaluation alone; an endeavour that may miss many significant visual problems.  The purpose of this article is to highlight the need for vision screening to be conducted in schools and for the screening protocols to include the various accommodative tests. A retrospective analysis of the amplitudes of accommodation, accommodative facility and accuracy of accommodation findingsfrom a primary school vision screening of 264 children between 6 and 13 years was undertaken in this study.  Data was captured and analysed with Microsoft Excel. The ages of the children ranged from 6 to 13 years with a mean of 9.38 years (SD = 1.85).  One hundred and thirty eight (52.3%) were males and 126 (47.7%) females.  A significant number of the children failed the monocular accommodative amplitude tests (24%), binocular accommodative amplitude test (26%), the accommodative facility (30%) and the MEM test (27%).  These results highlight the need for a more comprehensive vision screening exercise rather than VA alone as this approach would have  missed more than a quarter of the children who had other visual problems that could impact on their ability to perform optimally at school.