Binocular and Accommodative Dysfunction May Not Affect Clinical Testing Outcomes

Binocular and accommodative dysfunction does not significantly affect outcomes for patients undergoing the Developmental Eye Movement test (DEM) or Test of Visual Perceptual Skills (TVPS), according to research published in the Journal of Optometry. The degree of exotropia, however, does appear to have some correlation with horizontal DEM outcomes, according to the report.

Researchers included 110 children, consisting of individuals with strabismus and amblyopia (n=36; mean age, 9.07 years; 19 boys), patients with binocular and accommodative dysfunction (n=38; mean age, 8.48 years; 19 boys), and control group participants (n=36; mean age, 8.24 years; 18 boys) with normal binocular and accommodative functioning in the multicenter, retrospective investigation. Study participants underwent DEM and TVPS testing, and the research team compared visual perception and ocular motility outcomes among the 3 cohorts.

Vertical and horizontal DEM outcomes were comparable among all groups (P =.759 and P =.958, respectively), the report shows. The TVPS assessment yielded similar results, with no statistically significant difference in scores between the cohorts for any of the 7 testing domains (P ≥.118 for all).

A subgroup analysis of participants with strabismus and amblyopia examined correlations between DEM and TPVS outcomes and strabismus magnitude. While neither esotropia nor exotropia affected TPVS scores, the investigators observed a trend of correlation between exotropia magnitude and horizontal DEM scores (r, 0.367; P =.084).

“[T]here are no significant differences in performance in clinical tests such as the DEM and TVPS tests between strabismus, amblyopia, binocular and accommodative dysfunction, and subjects with normal binocular vision,” according to the study authors. “It seems that subjects with accommodative and binocular dysfunctions, strabismic or non-strabismic, can compensate for their abnormal visual development and reach normal
visual function in the specific areas assessed here.”

Study limitations include a retrospective nature.