Accommodative Facility Testing If the patient wears glasses for close work, these should be used. Hold Accommodative Rock Card 40 cm from the patient’s face at eye level and place the +2.00 lens in front of the patient’s eyes. The test is initially performed binocularly. PRROCEDURE Ask the patient to try to get the letters clear and single as quickly as possible. Instruct the subject to report (say “clear”) as soon as the letters are clear. When the letters are reported to be clear, quickly flip the flipper so the minus side is before the same eye, again instructing the subject to read the letters and report when the letters appear clear or if they disappear. Continue alternating sides of the flipper lenses for 1 minute, calculating the cycles per minute achieved (1 cycle = plus and minus). Repeat the procedure monocularly if the patient is unable to pass binocularly. The only difference in monocular testing is that the patient only has to report when the target is clear (diplopia is no longer an issue). Record the cycles per minute. Record if one side (plus or minus) of the flippers was more difficult, or if neither side was more difficult. EXAMPLES The patient can complete 18 flips in 1 minute. This equals 9 cpm. If the patient cannot clear −2.00 at all, record as 0 cpm, fails minus. If the patient cannot clear +2.00 at all, record as 0 cpm, fails plus. If the patient reports diplopia, record as 0 cpm, diplopia with +2.00 or diplopia with −2.00. IMP. POINTS Stress the importance of trying to keep the target both clear and single

1. By Babli Sharma
B.Optom, M.Optom

2.  Accommodative Rock Card
 +2.00/−2.00 flip lenses
Accommodative
Rock Card
+2.00/−2.00 flip lenses

3.  If the patient wears glasses for close work, these should be used.
 Hold Accommodative Rock Card 40 cm from the patient’s face at eye level and
place the +2.00 lens in front of the patient’s eyes.
 The test is initially performed binocularly.

4.  Ask the patient to try to get the letters clear and single as quickly as
possible.
 Instruct the subject to report (say “clear”) as soon as the letters are clear.
 When the letters are reported to be clear, quickly flip the flipper so the
minus side is before the same eye, again instructing the subject to read
the letters and report when the letters appear clear or if they disappear.
 Continue alternating sides of the flipper lenses for 1 minute, calculating
the cycles per minute achieved (1 cycle = plus and minus).
 Repeat the procedure monocularly if the patient is unable to pass
binocularly.The only difference in monocular testing is that the patient
only has to report when the target is clear (diplopia is no longer an issue).
 Record the cycles per minute. Record if one side (plus or minus) of the
flippers was more difficult, or if neither side was more difficult.

5.  The patient can complete 18 flips in 1 minute.This equals 9 cpm.
 If the patient cannot clear −2.00 at all, record as 0 cpm, fails minus.
 If the patient cannot clear +2.00 at all, record as 0 cpm, fails plus.
 If the patient reports diplopia, record as 0 cpm, diplopia with +2.00 or diplopia
with −2.00.

6.  Stress the importance of trying to keep the target both clear and single.

7. THANKYOU