Nores Palmás, NoeliaNoya Padín, VerónicaYebra-Pimentel Vilar, EvaGiráldez Fernández, María JesúsPena Verdeal, Hugo2024-10-232024-10-232024-10-18Nores-Palmas N, Noya-Padin V, Yebra-Pimentel E, Giraldez MJ, Pena-Verdeal H. Comparison of Four Methods for Measuring Heterophoria and Accommodative Convergence over Accommodation Ratio. Vision. 2024; 8(4):622411-5150https://hdl.handle.net/10347/37540The study aimed to assess the agreement between OptoTab SERIES, alternating Cover Test, Modified Thorington test, and Von Graefe method in measuring heterophoria and accommodative convergence over accommodation (AC/A) ratio. In an initial step, heterophoria was assessed at both distance and near in a cohort of 76 healthy young volunteers using the previously described tests. Subsequently, to determine the AC/A ratio, near-vision measurements were repeated with +1.00 D and −1.00 D lenses. All tests were performed in a randomized order across participants under consistent conditions. Significant differences were found between the Modified Thorington test and all other tests at distance (Wilcoxon test, all p ≤ 0.001) and between Von Graefe and all other tests at near (Wilcoxon test, all p ≤ 0.005). Regarding the AC/A ratio, significant differences were observed between all methods in +1.00 D AC/A ratio, except for the Modified Thorington test vs. the alternating Cover Test (Wilcoxon test, p = 0.024). In the −1.00 D AC/A ratio, differences were observed between OptoTab POCKET and all the other tests (Wilcoxon test, all p ≤ 0.001). The results indicate that all methods are interchangeable except the Modified Thorington test at distance and Von Graefe at near. For the AC/A ratio, only the Modified Thorington test is interchangeable with the alternating Cover Test using +1.00 D lenses and all are interchangeable using −1.00 D lenses except OptoTab POCKET.eng© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) licenseAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/HeterophoriaAC/A ratioOptoTab SERIESCover TestModified Thorington testVon Graefejournal article10.3390/vision8040062open access