A comparison of the conventional and modified push-up methods of measuring the near point of accommodation

Hareerm Esmail, Gemma Arblaster


Aim: To compare the subjective near point of accommodation measurement with the RAF rule using the conventional (clear to blur) and modified (blur to clear) push-up methods.

Methods: Both methods of testing the near point of accommodation were carried out uniocularly and binocularly in 32 visually normal participants (mean age: 20.08) with a range of visual experience.

Results: The modified push-up method (blur to clear) gave a near point of accommodation further away from the subject. A difference of 0.51 cm in the right eye, 0.61 cm in the left eye and 1.05 cm binocularly was found between the two methods which was statistically significant ( p < 0.05). No difference was found between naı¨ve and expert groups ( p < 0.05). However, most participants reported that the end point was easier to judge with the modified method.

Conclusion: Despite being significantly different statistically, the difference between the two methods measuring the near point of accommodation with the RAF rule was small. The findings support the use of the modified method of measuring the near point of accommodation with the RAF rule, rather than the conventional method.


Accommodation; Blur to clear; Clear to blur; Conventional push-up method, Modified push-up method; Near point of accommodation; RAF rule

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