There are a number of accommodative functions and it is often difficult to decide which of these functions are most applicable when testing accommodation in children.
The amplitude of accommodation is perhaps one of the most frequently measured visual functions to clinically determine the accommodative function of patients presenting with symptoms of binocular dysfunctions. Other tests of accommodative functions include lead/lag of accommodation, accommodative facility and a cycloplegic refraction (Wick & Hall, 1987). The lag/lead of accommodation represents the discrepancy between the accommodative stimulus and the response (Cooper, 1987; Saladin, 2006; Barret & Elliot, 2007). The lag of accommodation is believed to be due to the effect of the depth of focus of the eye (Flom, 1955; Rouse, et al., 1984; Cooper, 1987). Accommodative facility is the ability to alter accommodation with a change in the fixation distance (Wick & Hall, 1987) or lens induced blur (flipper lens test) (Saladin, 2006). These tests are necessary in order to diagnose accommodative anomalies such as accommodative insufficiency, accommodative excess as well as accommodative infacility (Scheiman & Wick, 2008).
Testing Accommodation in Children. Download and view here: Testing Accommodation in Children