When a young observer attempts to accommodate steadily on a fixed stimulus, the norminally steady‐state response shows small instabilities or fluctuations (sometimes termed microfluctuations or oscillations). These fluctuations typically have an amplitude of a few tenths of a dioptre and a frequency spectrum extending up to a few Hertz. The properties of these fluctuations are described for various viewing conditions: pupil diameter, target vergence, target form, target contrast, and target luminance all influence the frequency spectra of the oscillations, as may anomalies of vision such as amblyopia. The possible roles that the fluctuations might play in the function of the accommodative system are discussed. It is suggested that the higher frequency components around 2 Hz may arise from the mechanical and elastic characteristics of the lens, zonule and ciliary body. Components at lower frequencies (<0.5 Hz) may be of more significance in the function of the accommodative control system.

Purpose: Following the recognition, some 80 years ago, that the accommodation of the eye is not stable but fluctuates over a range of about AE0.5 D, mainly at frequencies of up to a few Hz, there has been a continuing interest in the characteristics of these microfluctuations (MFs) and their possible role in the control of accommodation. This paper reviews relevant work carried out since 1988, when we previously reviewed the same topic (Charman WN, Heron G. Fluctuations in accommodation: a review. Ophthalmic Physiol Opt 1988; 8: 153-164). Recent findings: Studies relating to the effects on the MFs of stimulus form, luminance and vergence are described, together with those of pupil diameter, age and ametropia. Important advances in the understanding of the links between the characteristics of the MFs and those of the cardiopulmonary system, higher-order aberrations and ocular depth-of-focus are outlined. Only limited progress has been made in understanding the role of MFs in accommodation control. Summary: While the dependence of the characteristics of the MFs in relation to observing conditions is now reasonably well understood, their involvement in accommodation control still needs clarification. The current consensus appears to be that any role is more likely to be concerned with maintaining an appropriate response, rather than in initiating responses to abrupt changes in stimulus vergence. Fluctuations at lower temporal frequencies (<0.6 Hz) are probably important to the control process, which may make use of the associated changes in the contrast and spatial frequency spectrum of the retinal image.

The experiments demonstrate a reduction in retinotopic processing in LOMs, which results in an increased variability in their dynamic accommodation response to stationary near targets and reduced performance for dynamic step tasks. The results demonstrate a reduced blur appreciation under dynamic conditions in these refractive groups that may lead to periods of retinal image blur of varying magnitude during near work.

When viewing real targets with size and disparity cues available, no significant differences in the accuracy of static and dynamic accommodation responses were found among EMM, EOM, and LOM. The results suggest that corrected myopes do not experience dioptric blur levels that are substantially different from emmetropes when they view free space targets.

A transverse study of the monocular, steady-state accommodation response/stimulus curves for 49 normal subjects with ages between 17 and 49 years shows that the slope of the curve reduces only slowly with age up to about 40 years and then declines rapidly as complete presbyopia is approached. Such behaviour appears to result from the accommodation system changing its characteristics with age to make optimal use of the available objective amplitude of accommodation and the depth-of-focus of the eye.