Introduction -Flipper frame is a holder with 2 minuses and 2 plus lenses. Focusing flippers helps to train the accommodative system in our eyes Which is responsible for changing focus from distance to near. A flipper mainly have magnifying lenses on one side that requires to relax your focus and minifying lenses on the other side that requires you to focus more .

Used to test accomodative facility testing ( how quickly you can stimulate and how quickly you can relax the accommodation.

Available in power : +/-0.50 , 1.00 , 1.50 , 2.00 , 2.50 , 3.50 .

Purpose – To measure the patient ability to make rapid accomodative changes under monocular and binocular condition.

Why to perform – Pt who are experiencing difficulty in reading or have poor adjustment when switching from looking at distance to near can be benefit from this therapy.

EQUIPMENT –

A accommodative flipper of +- 2.00 dshp.
Near vision test chart (Hart chart) .
Timer with second hand.

It’s should be practiced in a quiet area with good lighting while keeping distraction to a minimum.

Principal – Plus power relax the accommodation while minus lenses stimulated the accommodation So clinically accomodative facility can be measured using lenses that stimulates and relax the accommodation .

Procedure :

The Pt is ask to focus / read the Hart chart through the pair of lenses situated at distance of 40 cm.
When the object is clearly focused, a flip quickly perform to other lens pair and Pt is asked to focuses through them.
This is then repeated and the no of cycle completed in one min as recorded as accommodative facility.
Flippers can be perform monocular and binocular as per as the patient’s need.

Monocular Flipper : Place the eye patch over one eye and tell Pt to sit down straight .In this activity take ruler or take measure which measure 40 cm from the eyes to the reading material in front of view. Hold the flipper In front of Pt eyes Keeping in label to eye, then ask pt to read one or 2 lines of reading material with the lenses in front of eyes. Flip the lenses and again make read of 1-2 lines . Keep flipping the lenses as quickly pt clearly with one lenses. Continue flipping and reading 5-10 min then Switch the patch to other eye and repeat the activity.

Binocular flipper : same procedure as monocular except patching is not done. In short for monocular and binocular flippers ;

Monocular flippers :

use an eye patch.
Read one to 2 lines then flip the lenses .
Practice for 5 to 10 min daily.

Binoculars flippers :

Do not use an eye patch .
polaroid glasses , Red green
Try to read with out flipper first .
Practice for 5-10 min with flipper

Goal : keep letters single and clear as soon as possible .Be able to see through all the bar simultaneously .

Indication :

When patient complain he / she can see distance and near clearly but take time to clear it out.

Means have amplitude and have good relaxation and accommodation but can’t do quickly have difficulties means have accommodative facility .

Monocular – Accommodative role.

Binocular – Accommodative and convergence both play role.

Interpretation :

Record no. Of cycle in a minute.

1 cycle = plus to minus and back to plus again.

Expected value:

Binoculars : 8 cpm
Monocular : 10-12 cpm
Less than 5 cpm and slow both plus and minus : Vergence are not quit good and Pt is unable to do either the accommodation, convergence, divergence not working properly.
Difficulties with plus lenses : accommodation excess who can’t relax accommodation and convergence not working properly ( convergence insufficient).
Difficulties with minus lenses : presbyopes, pre -presbyopes and accommodation insufficiency.

Or divergence insufficiency or negative fusional Vergence not working properly