amplitude of accommodation
Also called accommodative amplitude, AA, AoA, push-up amplitude, Hofstetter's formula
The maximum amount of accommodation an eye can exert, expressed in diopters: the dioptric distance between the far point and the near point of clear vision, measured with the distance correction in place1,2,3. The amplitude falls steadily with age as the lens stiffens, and is close to zero by the seventies1.
In the push-up method a 20/30 target is brought toward one eye until the first sustained blur, and the amplitude is , with in diopters and the blur distance in centimeters4,6. The expected average amplitude is and the expected minimum is 2,4.
More detail
The amplitude differs from accommodative facility, which is the speed of change, and from the lag of accommodation, which is the accuracy at one distance. The push-up method overestimates the amplitude because the target grows larger as it approaches the eye, so the minus-lens method is used as a cross-check1,4. Measuring through minus 4.00 diopter lenses moves the endpoint farther away and makes the reading more exact, since at 5 cm an error of 1 cm is worth 4 diopters4. The test should be repeated at least three times to check for fatigue5.
Sources (6)
- Schwartz, Geometrical and Visual Optics, ch. 8, Accommodation (Table 8-1)
- Pickwell's Binocular Vision Anomalies, ch. 2
- AOA, Care of the Patient with Accommodative and Vergence Dysfunction, glossary
- Scheiman and Wick, Clinical Management of Binocular Vision, ch. 1
- Eperjesi and Rundström, Practical Binocular Vision Assessment, ch. 5
- Carlson and Kurtz, Clinical Procedures for Ocular Examination, ch. 2, Amplitude of Accommodation: Push-Up Method
Reviewed October 2026
Related terms
Nearby in the glossary
- alternate cover test
- amblyopia
- amblyopiagenic
- amplitude of accommodation
- angle kappa
- angle of anomaly
- angle of deviation