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Test-retest reliability of clinical accommodative measures in adolescents
Journal article   Peer reviewed

Test-retest reliability of clinical accommodative measures in adolescents

Angela M Chen, Chris Koutures, Loraine T Sinnott, Ann Morrison, Carissa Wu, Caitlyn Lew, Matthew Vaughn, Emily K Wiecek, Mitchell Scheiman, Lisa A Jordan, …
Optometry and vision science, v 103(2), e70012
Feb 2026
DOI: https://doi.org/10.1002/ovs2.70012
PMID: 41922925

Abstract

Accommodation, Ocular - physiology Adolescent Child Female Follow-Up Studies Humans Male Reproducibility of Results Vision Tests - methods Vision, Binocular - physiology Visual Acuity
To determine long-term (3 months) test-retest reliability of accommodative testing in adolescents with normal accommodative amplitude. Participants aged 12 years to <17.5 years with normal accommodative amplitude (minimum of 11 diopters [D]) and binocular vision were enrolled. Three trials of monocular accommodative amplitude using the push-up method and one trial of monocular accommodative facility with ±2.00 D flipper lenses were performed at the initial and 90-day retest visits. Bland-Altman analyses of within-participant differences between initial and 90-day retest visits were performed. Ninety-three participants (mean age 14.3 ± 1.6 years; 51% female) were enrolled, and 91 of 93 (98%) participants completed both visits. At the initial visit, the mean accommodative amplitude was 13.95 D and 14.32 D in the right and left eyes, respectively, and the mean accommodative facility was 10.16 and 10.19 cycles per minute (cpm) in the right and left eyes, respectively. Although no significant difference was observed in accommodative amplitude between the initial and retest visits, a significant but clinically small difference was observed in facility. The 95% limits of agreement were large for amplitude (right eye -3.96 to 3.63 D and left eye -4.92 to 4.13 D), particularly in those with initial amplitude exceeding 14 D, and for facility (right eye -6.43 to 9.44 cpm and left eye -7.54 to 10.8 cpm). In adolescents with normal accommodative amplitude and binocular vision, test-retest differences in accommodative amplitude and facility were small; however, the variability was high, especially for accommodative facility.

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