How to Measure Accommodative Lag

[@Blacksquareable]

Aha! I had this test done on the phoropter a couple of years ago which gave me a result of some 7 diopters of difference. This was actually quite a neat way of doing it. The phoropter was clicking quite loudly as it shuffled quickly through all the changes.

[@nimalidangampala159]

Hi can you explain how much should be the normal lag and lead

[@sea4see]

Great video !!!👍🏻👍🏻👍🏻👍🏻

[@MyopiaProfile]

Thank you!

[@pigu8734]

I find that my lag is worse in my SV contacts, myopia control MFCLs and glasses. My lag is the lowest with the testing flippers. Could it be due to the high +ve spherical aberration properties of the flipper lens creating a higher accommodative stimulus? I am of East Asian decent and very insensitive to blur. My habitual wear is lackluster during schoolwork but my optometrist keeps telling my mom my eyes are fine

[@UbuntuOphthalm]

From where can i get these flippers that you had used in the clinic? please, share the link

[@UbuntuOphthalm]

Any help, please

[@MyopiaProfile]

@@UbuntuOphthalm we're in Australia and got them from a local company (Cyclopean Designs) but we've seen them online for sale via eBay and AliExpress - search 'optical flipper'.

[@abeibrahim5846]

Hi, Great tutorial - I am in need of glasses, but I can't find a doctor that has a variable measuring practice (i.e. Binocular focus system) that one can adjust to the desired distance than the doctor would measure its value. Multi-lens measuring systems confuse my brain and one fears selecting one of the last two choices and ending up with glasses that degrade one's vision rather than help it - why on earth technology has not reached this, and we still using 100 years old system.... I can't understand it for the life in me.

[@MyopiaProfile]

Hi Abe, us eye doctors do need to measure your prescription for far and for close, at set distances. This provides standardised information for past and future comparison. We then use this information, along with knowledge about your visual environment and activities, to determine the best prescription and best type of spectacle lenses for you. If you're struggling to make the 'forced choice' options of what we call subjective refraction ('subjective' as we're asking for your feedback), ask if your eye doctor can make an objective measure of your refraction instead. There are a couple of techniques (retinoscopy and autorefraction) which are objective, taking the guesswork away. We use these techniques as a starting place and it might be the finishing place for those who can't tell us otherwise, but for most adults we will also want to ask your opinion about what looks clearer to you.

[@midoriuehara3602]

So the amount where the reflex is neutral is the amount of lag?

[@MyopiaProfile]

Yes, indeed! No working distance lens or additional calculation is required.

[@ugowoundo]

Does a high lag mean you reduce the myopic prescription and by how much?

[@MyopiaProfile]

Not necessarily. A high lag means that the person is working harder at near with their distance prescription. Reducing the distance prescription will cause blurred vision, if the prescription has been measured accurately. So, usually a high lag necessitates spectacles which provide a reading add such as progressive addition lenses.

[@ugowoundo]

@@MyopiaProfile Thank you so much

[@Emily-dn3cs]

Is accommodative lag and myopia progression a risk for children only or adults too?

[@MyopiaProfile]

It appears to be a risk for adults as well, but we don't have a lot of data on it. Here's a summary with links to scientific papers: www.myopiaprofile.com/measuring-near-lag-of-accommodation/

[@rashellecohen14]

Kate what do you prescribe with an anisometropic hyoperopic amblyope who has say a +0.75 lag in the dominant eye and +1.50 lag in the amblyopic eye? Also don't you test both eyes ?

[@MyopiaProfile]

Hi Rashelle, yes I definitely test both eyes, every time. As for prescribing in the situation you describe, I would want to ensure the dominant eye is comfortable while also trying to provide the amblyopic eye as much support as needed. Typically, for non-strabismic patients who need an add, I would prescribe +0.50 less than the near lag, to allow for comfortable near vision. I'd prescribe more than this, up to the full value of the lag, if we also have to deal with esophoria/tropia. In this case, if the amblyopic eye really needs that extra plus at near, I'd consider giving a +0.75 add (the full lag of the dominant eye).

[@endothelialpump]

Top notch.

[@MyopiaProfile]

Thanks Phil!

[@vikasbhadouriya113]

How much flipper rate

[@vikasbhadouriya113]

How much

[@erickcartman7104]

When you use the flippers you make it binocular and the test is monocular

[@barneyandhannah]

Yes. I understood MEM to be a monocular technique - the patient views the target binocularly, but the lens/flipper is very briefly (

[@MyopiaProfile]

@@barneyandhannah yes you're correct. You can only test one eye at a time, but you can quickly change lenses to avoid adaptation, and test with different powers. Holding the flipper up for longer in this video allows for demonstration of the technique.

[@MyopiaProfile]

Holding up the flippers binocularly has the advantage of providing both eyes with the same demand / blur, even if it is done very quickly. It can help to avoid the patient fixing /accommodating with the non-tested eye which could influence the results.

[@davidjyothiopticals7699]

TQ madam

[@mambrinox]

I don't think you know what you are talking about

[@MrSRMatthews]

Ha ha ha she has a PhD and is a leading expert in the field 😅

[@vikasbhadouriya113]

Flipper

[@sarfarazkhan-zz2fi]

Boring I don't understand