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Sources of error in clinical measurement of the amplitude of accommodation

Burns, D. H., Allen, P. M., Edgar, D. F. ORCID: 0000-0001-9004-264X & Evans, B. J. W. (2019). Sources of error in clinical measurement of the amplitude of accommodation. Journal of Optometry, doi: 10.1016/j.optom.2019.05.002


Measurement of the amplitude of accommodation is established as a procedure in a routine optometric eye examination. However, clinical methods of measurement of this basic optical function have several sources of error. They are numerous and diverse, and include depth of focus, reaction time, instrument design, specification of the measurement end-point, specification of the reference point of measurement, measurement conditions, consideration of refractive error, and psychological factors. Several of these sources of inaccuracy are composed of multiple sub-sources, and many of the sub-sources influence the common methods of measurement of amplitude of accommodation. Consideration of these sources of measurement error casts doubt on the reliability of the results of measurement, on the validity of established normative values that have been produced using these methods, and on the value of reports of the results of surgery designed to restore accommodation. Clinicians can reduce the effects of some of the sources of error by modifying techniques of measurement with existing methods, but a new method may further improve accuracy.

Publication Type: Article
Additional Information: © 2019 Spanish General Council of Optometry. Published by Elsevier Espa ̃na,S.L.U.This is an open access article under the CCBY-NC-ND license (
Publisher Keywords: Amplitude of accommodation, Accommodative amplitude, Measurement error, Clinical, Push-up
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences
Text - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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