Abstract

Study design: Accommodation was assessed with dynamic ophthalmoscopy and compared with dynamic retinoscopy in 1054 children in the masked manner. Multiple videos and photographs were recorded and processed using Apple iphone12 to harness 11 best photos to create an "Accommodation scale” with the range of 0D to +5.0D in the step of 0.5D. Results: Using the scale, the magnitude of accommodation was assessed within ±0.25 (0.5D, range 0.1D – 0.7D) of accuracy by 18 fellowship trained pediatric ophthalmologists with an average experience of 5.8 years after fellowship (range 6months – 19years). Sixteen pediatric ophthalmologists felt very confident with the assessment of the magnitude of accommodation using the “Accommodation scale.” The technique had a high sensitivity (94%), specificity (100%), negative and positive predictive values (99%, 100%), correlation coefficient (r) (>92) and Cohen’s kappa (0.97). Conclusion: The ‘Accommodation scale’ was validated to be accurate and reliable.

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