{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:49:53Z","timestamp":1791841793445,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2023,7]]},"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n The \u00b12.00 D accommodative facility test presents several limitations, including the lack of objective information and inherent characteristics such as vergence\/accommodative conflict, change in apparent size of the image, subjective criteria for judging blur and motor reaction time. By using free\u2010space viewing conditions and an open\u2010field autorefractor to monitor the refractive state, we examined the impact of manipulating these factors on the qualitative and quantitative assessment of accommodative facility.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Twenty\u2010five healthy young adults (24.5\u2009\u00b1\u20094.5\u2009years) took part in this study. Participants performed three accommodative facility tests (adapted flipper, 4D free\u2010space viewing and 2.5D free\u2010space viewing) under both monocular and binocular conditions in random order. A binocular open\u2010field autorefractor was used to assess the accommodative response continuously, and these data were used to characterise accommodative facility quantitatively and qualitatively.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were statistically significant differences between the three testing methods both quantitatively (\n p<\/jats:italic>\n \u2009<\u20090.001) and qualitatively (\n p<\/jats:italic>\n \u2009=\u20090.02). For the same accommodative demand, a lower number of cycles was obtained for the adapted flipper condition in comparison with the 4D free\u2010space viewing test (corrected\n p<\/jats:italic>\n \u2010value\u2009<\u20090.001, Cohen's d\u2009=\u20090.78). However, this comparison did not reach statistical significance for qualitative measures of accommodative facility (corrected\n p<\/jats:italic>\n \u2010value\u2009=\u20090.82, Cohen's d 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These data provide evidence that the qualitative assessment of accommodative facility is not influenced by the inherent limitations of the \u00b12.00 D flipper test. The use of qualitative outcomes by incorporating an open\u2010field autorefractor allows examiners to increase the validity of the accommodative facility test in both clinical and research settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/opo.13136","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T13:38:46Z","timestamp":1680356326000},"page":"660-667","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of manipulating the vergence\/accommodation and image size mismatches of the \u00b1\n 2D<\/scp>\n flipper test on the frequency and precision of accommodative facility"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8091-2373","authenticated-orcid":false,"given":"Jes\u00fas","family":"Vera","sequence":"first","affiliation":[{"name":"CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group Department of Optics Faculty of Sciences University of Granada Granada Spain"},{"name":"New England College of Optometry Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4571-873X","authenticated-orcid":false,"given":"Beatriz","family":"Redondo","sequence":"additional","affiliation":[{"name":"CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group Department of Optics Faculty of Sciences University of Granada Granada Spain"},{"name":"New England College of Optometry Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Miguel","family":"Mart\u00ednez\u2010Tovar","sequence":"additional","affiliation":[{"name":"CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group Department of Optics Faculty of Sciences University of Granada Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"Molina","sequence":"additional","affiliation":[{"name":"CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group Department of Optics Faculty of Sciences University of Granada Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1610-6240","authenticated-orcid":false,"given":"George A.","family":"Koulieris","sequence":"additional","affiliation":[{"name":"Department of Computer Science Durham University Durham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-7215","authenticated-orcid":false,"given":"Peter M.","family":"Allen","sequence":"additional","affiliation":[{"name":"Vision and Hearing Sciences Research Centre School of Psychology and Sports Sciences Anglia Ruskin University Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8036-2532","authenticated-orcid":false,"given":"Raimundo","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group Department of Optics Faculty of Sciences University of Granada Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"31","article-title":"A review of the literature and a normative study of accommodative facility","volume":"55","author":"Zellers JA","year":"1984","journal-title":"J Am Optom Assoc"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-1313.2000.00478.x"},{"key":"e_1_2_10_4_1","first-page":"173","article-title":"Clinical testing of accommodative facility: part III. Masked assessment of the relation between visual symptoms and binocular test results in school children and adults","volume":"73","author":"Wick B","year":"2002","journal-title":"Optometry"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-1078"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.visres.2005.05.007"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clae.2006.08.004"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0042-6989(88)90098-3"},{"key":"e_1_2_10_9_1","volume-title":"Clinical procedures in primary eye care","author":"Elliott DB","year":"2020"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2018.1444181"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2019.1688837"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2021.1962359"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/135062899394885"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.2004.00202.x"},{"key":"e_1_2_10_15_1","volume-title":"Clinical management of binocular vision: heterophoric, accommodative, and eye movement disorders","author":"Scheiman M","year":"2008"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-013-2480-7"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-1313.1999.00396.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000000402"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-1313.2001.00597.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1993.sp019515"}],"container-title":["Ophthalmic and Physiological Optics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/opo.13136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:23:45Z","timestamp":1767785025000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/opo.13136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/opo.13136"],"URL":"https:\/\/doi.org\/10.1111\/opo.13136","archive":["Portico"],"relation":{},"ISSN":["0275-5408","1475-1313"],"issn-type":[{"value":"0275-5408","type":"print"},{"value":"1475-1313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2022-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}