Table 4.

Diagnostic criteria used for accommodative anomalies.

Dysfunction	Study	Diagnostic criteria
		Symptoms	Clinical signs
			AA	MAF	BAF	MEM	PRA	NRA	Visual acuity	Refractive error
Accommodative insufficiency	2006, Marran LF37	CISS V-15 symptom questionnaire	Monocular AA 2 D ≤ Hofstetter's minimum age formula: 15–0.25 × age Monocular Push up method
	2006, Sterner B38	Reported by several questions	AA < 8 D monocular and < 10 D binocular AA Monocular Push-up method
	2002, García, Aa 41	Reported without questionnaire	Reduced AA: at least 2 D < minimum age appropriate amplitude of Hofstetter's formula (15–0.25 × age) Monocular Push-up method	≤6 cpm Difficulty clearing −2 D (±2 D)	≤3 cpm Difficulty clearing −2 D (±2 D)	>+0.75 D	≤1.25 D
	2002, Cacho Pb 29	Reported without questionnaire	Reduced AA: at least 2 D < minimum age appropriate amplitude of Hofstetter's formula (15–0.25 × age) Monocular Push-up method	≤6 cpm Difficulty clearing −2 D (±2 D)	≤3 cpm Difficulty clearing −2 D (±2 D)	>+0.75 D	≤1.25 D
	1991, Dwyer PS4	Not reported	AA 3 D < Hofstetter's formula: 15–0.25 × age		Blurred with −2 D (±2 D)	≥+1.00 D	≤1.00 D
	1988, Chrousos GA45	Reported without questionnaire	AA below the normal for the patients’ ages Monocular push-up method
Accommodative excess	2002, García, Ac 41	Reported without questionnaire		≤6 cpm Difficulty clearing −2 D (±2 D)	≤3 cpm Difficulty clearing +2 D (±2 D)	<0 D	High finding ≥3.50 D	≤1.50 D	Variable	Variable retinoscopy and subjective refraction
	1991, Dwyer PS4	Not reported			Blurred with +2 D (±2 D)	≤−0.50 D		≤1.00 D
	1988, Rutsein RP42	Reported without questionnaire				A lead movement. Value not specified			Varies. May be somewhat reduced	Varies (frequently emmetropia)
Accommodative infacility	1991, Dwyer PS4	Not reported		Disorder of facility (values not specified)

AA: accommodative amplitude, MAF: monocular accommodative facility, BAF: binocular accommodative facility, MEM: MEM dynamic retinoscopy, PRA: positive relative accommodation, NRA: negative relative accommodation.

^aAuthors consider AA and MAF as fundamental signs and patients must have at least two signs of the rest of three signs.

^bAuthors consider AA and MAF fundamental signs, being BAF, MEM and PRA complementary signs.

^cAuthors consider VA, Refractive error and MAF as fundamental signs and patients must have at least two signs of the rest of three signs.