Absence of pupil response to blur-driven accommodation

Phillips, Nicholas J.; Winn, Barry; Gilmartin, Bernard

doi:10.1016/0042-6989(92)90170-n

Cited by 35 publications

(37 citation statements)

References 18 publications

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“…[20] However, Phillips et al . [21] showed minimal change in pupil size when accommodation was stimulated with blur-driven accommodation alone. They suggested that cues such as target size and/or proximity may be a more significant stimulus.…”

Section: Discussionmentioning

confidence: 99%

Accommodative amplitude using the minus lens at different near distances

Momeni‐Moghaddam

Cesana

et al. 2017

Indian J Ophthalmol

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Purpose:The purpose of this study was to compare the mean findings and the repeatability of the minus lens (ML) amplitude of accommodation (AA) at 33 cm and 40 cm.Materials and Methods:AA was measured from the dominant eye of 120 fully corrected subjects using the ML procedure when viewing the target at both 33 and 40 cm. Each measurement was repeated between 24 and 48 hours after the first trial.Results:Mean AA when tested at 33 cm and 40 cm was 10.20 diopter (D) (standard deviation [SD] =1.24) and 8.85 D (SD = 1.23), respectively (P < 0.001). The limits of agreement of the measured amplitude calculated with taking into account of the replicates at 33 and 40 cm were − 0.19 (95% confidence interval [CI]: −0.34 to −0.04) and 2.53 (95% CI: 2.38 to 2.68), respectively. The repeatability of testing at the two distances 33 and 40 cm was ± 1.24 and ± 0.99, respectively. In addition, the retest reliability of measured amplitude using the intraclass correlation coefficient was 0.87 (95% CI: 0.789–0.920) at 33 cm and 0.91 (95% CI: 0.872–0.945) at 40 cm.Conclusion:There is no agreement in the obtained amplitude at the two measurement distances. Testing the ML AA at 40 cm may be superior given that a lower repeatability coefficient was observed. However, it is unclear whether the larger amplitude measured at 33 cm reflects a larger increase in accommodation (greater proximity effect) or a decrease in the ability to perceive the first slight sustained blur.

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Section: Discussionmentioning

confidence: 99%

Accommodative amplitude using the minus lens at different near distances

Momeni‐Moghaddam

Cesana

et al. 2017

Indian J Ophthalmol

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“…Pupil constriction is a co‐movement in near vision under independent control, which is not directly driven by other members of the near triad 65 . While pupil constriction (accommodative miosis) generally occurs in response to a near stimulus, as observed at least as early as Scheiner in 1615, 1 this is by no means always the case and there are wide individual variations in the extent of the constriction in subjects of the same age 66–71 . Near miosis appears to be almost absent for most pre‐teen subjects 68,69 .…”

Section: Accommodation In the Young Adultmentioning

confidence: 99%

The eye in focus: accommodation and presbyopia

Charman

2008

Clinical and Experimental Optometry

206

136

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Current understanding of the anatomy, function and performance of the accommodative system of the young, adult human eye is outlined. Most major current models of the accommodative mechanism are based on Helmholtz's original ideas but, despite of a growing volume of related research, uncertainty continues over the relative contributions made to the overall mechanism by different ocular structures. The changes with age are then discussed. Although the amplitude of accommodation decreases steadily from later childhood, the speed and accuracy of the system within the available amplitude are little impaired until the age of about 40, when the amplitude falls below that needed for normal near work. A review of the available evidence on age-related change in the lens, capsule, ciliary body and other relevant ocular structures confirms that geometric and viscoelastic lenticular changes play major roles in the progressive loss of accommodation. Other factors may also contribute in an, as yet, unquantified way and a full understanding of the origins of presbyopic change remains elusive.

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“…Early studies found that the PNR was more closely associated with accommodation than with convergence (13, 94, 191, 233, 234). Later studies found a greater association with convergence (16, 171), and even showed that the PNR could be totally absent during certain blur driven accommodative responses (292, 352). These conflicting results are likely a product of an incomplete disassociation between the convergence and accommodation systems during these experiments, as these two systems have been shown to be highly interdependent.…”

Section: Autonomic Control Of the Pupilmentioning

confidence: 99%

Autonomic Control of the Eye

McDougal

Gamlin

2014

Comprehensive Physiology

330

369

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The autonomic nervous system influences numerous ocular functions. It does this by way of parasympathetic innervation from postganglionic fibers that originate from neurons in the ciliary and pterygopalatine ganglia, and by way of sympathetic innervation from postganglionic fibers that originate from neurons in the superior cervical ganglion. Ciliary ganglion neurons project to the ciliary body and the sphincter pupillae muscle of the iris to control ocular accommodation and pupil constriction, respectively. Superior cervical ganglion neurons project to the dilator pupillae muscle of the iris to control pupil dilation. Ocular blood flow is controlled both via direct autonomic influences on the vasculature of the optic nerve, choroid, ciliary body, and iris, as well as via indirect influences on retinal blood flow. In mammals, this vasculature is innervated by vasodilatory fibers from the pterygopalatine ganglion, and by vasoconstrictive fibers from the superior cervical ganglion. Intraocular pressure is regulated primarily through the balance of aqueous humor formation and outflow. Autonomic regulation of ciliary body blood vessels and the ciliary epithelium is an important determinant of aqueous humor formation; autonomic regulation of the trabecular meshwork and episcleral blood vessels is an important determinant of aqueous humor outflow. These tissues are all innervated by fibers from the pterygopalatine and superior cervical ganglia. In addition to these classical autonomic pathways, trigeminal sensory fibers exert local, intrinsic influences on many of these regions of the eye, as well as on some neurons within the ciliary and pterygopalatine ganglia.

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Absence of pupil response to blur-driven accommodation

Cited by 35 publications

References 18 publications

Accommodative amplitude using the minus lens at different near distances

Accommodative amplitude using the minus lens at different near distances

The eye in focus: accommodation and presbyopia

Autonomic Control of the Eye

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