June 1987

Training Accommodation—Cooper eta!.

433

After baseline assessment, each patient experi-

enced either a control condition or an experimental

condition in the first phase (phase 1 group). Conditions

in phase 2 were reversed.

b All change scores represent the difference in ac-

commodative amplitude after a training condition (either

experimental or control) from the immediately prior

phase (i.e., baseline, control, or experimental).

over treatments, asthenopia scores improved for

the control group (12.3) but remained constant

for the experimental group (12.5). A sign test

for ranked data’7 revealed a statistically signifi-

cant difference between the effects of experi-

mental (accommodative demand lenses) and

control (piano lenses) conditions (p = 0.031)

with regard to asthenopia.

Table 2 shows each patient’s asthenopia

change score after exposure to experimental and

control conditions. The original order of group

assignment is also indicated. It is apparent that

every patient showed a greater improvement in

asthenopia score after accommodative demand

training than after placebo training. Table 2 also

shows that there was virtually no change in

asthenopia score after control training, whereas

more than a four point change occurred after

experimental training.

Before experimental training, none of the five

patients were able to clear a —2.00 D lens inter-

posed before each eye (accommodative facility).

After training, four of five patients made instan-

taneous accommodative changes to clear both a

—2.00 D lens and a +2.00 D lens. The one patient

who failed to improve accommodative facility

also showed minimal improvement in accom-

modative amplitude and in asthenopia reduc-

tion.

Analysis of phorias, refractive status, fusional

ranges, stereopsis, and lag of accommodation

showed no significant difference before and after

accommodative therapy. Positive relative ac-

commodation findings improved but the changes

were not statistically significant, p < 10.

DISCUSSION

This study shows that monocular accommo-

dative facility training results in an improve-

FIG. 2. The abscissa depicts the three phases of testing, i.e., baseline, phase 1, and phase 2. Mean

accommodative amplitude for all patients in each phase (determined by minus lens to blur) is plotted on the

ordinate. Open squares (0) represent patients who received experimental, accommodative training, during phase

1 and placebo during phase 2. Closed squares ~) represent patients who received the opposite condition, i.e.,

phase 1, control (placebo); phase 2, accommodative training.