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Background: Accommodative facility testing is a common test performed by optometrist to investigate an individuals skill at focusing objects at near and at far. The traditional test however harbors possible confounding variables including individual variance in reaction time, visual acuity, verbal skills and oculomotor function. We have designed a test procedure to control these variables. Methods: Children were evaluated with a traditional accommodative facility test, a test which evaluated reaction time and language skill but without accommodative (plano lenses) and a test which evaluated reaction time, language skill and accommodative facility (+/- 2.00 D lenses). Results: Speed of reaction time was 2.9 sec/cycle for the plano lenses (for dominant eye). Speed of reaction with +/- 2.00 D lenses was 6.6 sec/cycle for dominant eye and the monocular speed of accommodations was calculated to average 3.7 sec/cycle. Normative data reported in the literature was calculated to be 5.5 sec/cycle. Discussion: We found that both our method which controls for confounding variables the traditional method reveal similar findings but that individual subjects would pass one method and fail the other. This is attributed to variation in the reaction time and digit naming skill. Conclusions: Although both methods reap similar results, both methods should be employed to discover, in those who score below the expected finding, to tease out whether or not the fault falls within the reaction time/language area or whether it is a true accommodative facility dysfunction.
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