Examining the Validity of a New Method for the Objective Assessment of Binocular Accommodative Facility (2Q-AF Test): A Comparison with +/- 2.00 DS Lens Flippers

Purpose Recent technological advances have permitted to objectively record the accommodative response while shifting between two different levels of accommodation. This study is aimed at examining the concurrent validity of a new objective method for the qualitative and quantitative assessment of binocular accommodative facility, which is named 2Q-AF test, in comparison to the +/- 2.00 DS lens flippers. Methods Fifty-six individuals took part in this study (36 healthy young adults [24.4 +/- 3.2 years] and 20 children [12.2 +/- 0.4 years]). Participants randomly performed the 2Q-AF and the +/- 2.00 DS lens flipper tests. For the 2Q-AF test, a binocular open-field autorefractor was used to record the magnitude of accommodative response during a 60-sec period, while participants repeatedly changed fixation from a 5 m to a 40 cm chart when clarity of vision was achieved at each level. Due to the advantages of the proposed method, we have determined the number of cycles and the 2Q-AF score, with the latter also considering the accuracy of changes in accommodation. A standard procedure was followed for the +/- 2.00 DS flipper test. Results Our data exhibited a moderate association between the number of cycles with the +/- 2.00 DS lens flippers and the number of cycles in the 2Q-AF test in the group of young adults (p = .005, r = 0.46 [0.15-0.68]) and children (p = .007, r = 0.58 [0.19-0.81]), whereas a stronger relationship was observed when considering the number of cycles with the +/- 2.00 DS lens flippers and the 2Q-AF score (young adults: p < .001, r = 0.83 [0.69-0.91]; and children: p < .001, r = 0.78 [0.52-0.91]). Conclusions The current findings show that the 2Q-AF test is a valid method for accommodative facility assessment, as suggested by its good levels of reliability and validity. This method allows to examine the accommodative facility in qualitative terms and solve most of the limitations associated with the +/- 2.00 DS lens flipper test.