Evidence of the Amplitude of Accommodation of School-Going Children in the 21st Century

Alvin Jeffrey Munsamy; Andile Ngema; Seyuri Bisetty; S'fundo Lushaba; Nomvelo Mayaba; Bongakonke Mthiyane; Nombuso Nyathi; Amen Thabethe

doi:10.22599/bioj.303

Evidence of the Amplitude of Accommodation of School-Going Children in the 21^st Century

Br Ir Orthopt J. 2023 Jun 20;19(1):52-63. doi: 10.22599/bioj.303. eCollection 2023.

Authors

Alvin Jeffrey Munsamy¹, Andile Ngema¹, Seyuri Bisetty¹, S'fundo Lushaba¹, Nomvelo Mayaba¹, Bongakonke Mthiyane¹, Nombuso Nyathi¹, Amen Thabethe¹

Affiliation

¹ University of KwaZulu-Natal, ZA.

Abstract

Purpose: The study sought to compare the normative amplitude of accommodation (AoA) in school-going children from studies in the 21st century, based on pooled estimates from meta-analyses, to assess their agreement to Hofstetter's average formula.

Methods: A PRISMA checklist was used to conduct the review. PubMed, EBSCOHOST and Medline electronic databases were employed, and hand searching resulting in 259 studies up to July 2021. After title and abstract screening, 12 studies underwent full-text screening, resulting in five studies for data extraction. The pooled effect size was determined using meta-analyses for sub-groups by age. A one-sample t-test was used to compare the pool-effect size estimates (monocular) to the expected AoA from Hofstetter's average formula.

Results: The comparison of pool estimates of AoA with the expected Hofstetter's average formula for the age sub-groups showed significant mean differences for: six-year olds: mean difference of -3.4 D (95% CI: -5.85; -1.04; p = 0.025); nine-year olds: mean difference of -4.1D (95% CI: -7.95; -0.20; p = 0.043); ten-year olds: mean difference of -4.6D (95% CI: -8.57; -0.54; p = 0.035) and 11-year olds: mean difference of -5.2 D (95% CI: -8.06; -2.40; p = 0.005). According to the quality assessment tool used, overall, the body of evidence was of good quality.

Conclusion: Hofstetter's prediction of normative amplitude of accommodation today may over-estimate for children aged six, nine, 10 and 11. The observed under-accommodation estimates from these comparisons may warrant consideration in assessing for a larger lag of accommodation in these age groups with myopia or pre-myopia, as part of the surveillance for progression.

Keywords: Hofstetter; accommodation; amplitude of accommodation; myopia; push-up method; schoolchildren.

Publication types

Review

Grants and funding

A University of KwaZulu-Natal (UKZN), Developing Research Innovation, Localisation and Leadership in South Africa (DRILL) fellow. DRILL, is a NIH D43 grant (D43TW010131) awarded to UKZN in 2015 to support a research training and induction programme for early career academics. The content is solely the responsibility of the authors and does not necessarily represent the official views of DRILL and the National Institutes of Health. DR ZG Dessie for statistical analysis.