Accommodative Facility in Eyes with and without Myopia

Pandian, Ashok; Sankaridurg, Padmaja; Naduvilath, Thomas; O’Leary, Daniel J.; Sweeney, Deborah F.; Rose, Kathryn A.; Mitchell, Paul

doi:10.1167/iovs.05-1078

Cited by 38 publications

(54 citation statements)

References 36 publications

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“…They reported reduced rates in myopes, but this difference was only significant at distance (9.7 cpm for myopes and 15.7 cpm for emmetropes). A similar result has been reported by Pandian et al 32 in a large sample of school children (1328 total; 977 emmetropes, 331 hyperopes, and 20 myopes). Furthermore, in a more recent investigation, Allen and O'Leary 33 investigated various accommodative functions to determine the natural progression of refractive error in 64 young adults (30 myopes and 34 non-myopes) during a period of 12 months.…”

Section: Discussionsupporting

confidence: 88%

Accommodative Training to Reduce Nearwork-Induced Transient Myopia

Vasudevan

Ciuffreda²,

Ludlam³

2009

Optometry and Vision Science

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Section: Discussionsupporting

confidence: 88%

Accommodative Training to Reduce Nearwork-Induced Transient Myopia

Vasudevan

Ciuffreda²,

Ludlam³

2009

Optometry and Vision Science

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“…The accumulative effects of accommodation eventually cause the structural elongation of the eyeball in the myopic eye. [22][23][24] Our study showed a decrease in AA postoperatively, and CT increased as AA reducing after surgery. We proposed that after correcting the refractive error, retinal images become clearer.…”

Section: Discussionmentioning

confidence: 49%

“…We postulated that there may be two major reasons as followings: (1) poor accommodative facility and slow accommodative responsiveness were existed in myopic people with accommodative lag, 24,25 which would result in low accommodation reserve of myopia patients. (2) Accommodation demand was increased at the early postoperative period because of post apex moved backward to cornea and overcorrection early postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Change in choroidal thickness and the relationship with accommodation following myopic excimer laser surgery

Cheng

Yuan

et al. 2016

Eye

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Purpose To investigate early changes in choroidal thickness (CT) and the relationship with accommodation after myopic excimer laser surgery. Methods We enrolled the right eye of 70 patients with myopia and without other ophthalmic or systemic diseases who were suitable for myopic excimer laser surgery. The CT was measured at the fovea and at distances of 0.5 and 2.5 mm for the following: nasal; temporal; superior; and inferior to the fovea preoperatively and at 1 month postoperatively. Other data collected included demographic information (age, sex, and refractive error), the amplitude of accommodation (AA), intraocular pressure, axial length, corneal thickness, and surgical parameters. The data were analyzed with a paired Student's t-test, stepwise linear regression, and correlation analysis. Results The CT was significantly thicker postoperatively compared with the preoperative CT. The AA significantly decreased postoperatively. The change in the AA was the most significant factor associated with the change in the CT at the fovea. Except for 2.5 mm inferior to the fovea, the increase in the CT at other locations was positively correlated with the decrease in the AA. Conclusions The CT increased following myopic excimer laser surgery and the change was most obvious when accompanied by a decrease in the AA early after the surgery.

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“…Researchers have suggested that various oculomotor factors may be related to the development, progression, and stabilization of myopia including poor accommodative response [2–8], decreased accommodative tonus [9], decreased accommodative amplitude [10], reduced accommodative facility [11–13], increased accommodative adaptation [14], increased accommodative variability [15], near phoria [16], and AC/A ratio [8, 17, 18]. Both animal [19, 20] and human [3, 21] research have led to the development of a theory referred to as the “blur hypothesis.” This theory suggests that retinal defocus caused by underaccommodation may be a factor related to myopia development and progression [3, 21].…”

Section: Introductionmentioning

confidence: 99%

Effect of Vision Therapy on Accommodation in Myopic Chinese Children

Ming-Leung

Scheiman

et al. 2016

Journal of Ophthalmology

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Introduction. We evaluated the effectiveness of office-based accommodative/vergence therapy (OBAVT) with home reinforcement to improve accommodative function in myopic children with poor accommodative response. Methods. This was a prospective unmasked pilot study. 14 Chinese myopic children aged 8 to 12 years with at least 1 D of lag of accommodation were enrolled. All subjects received 12 weeks of 60-minute office-based accommodative/vergence therapy (OBAVT) with home reinforcement. Primary outcome measure was the change in monocular lag of accommodation from baseline visit to 12-week visit measured by Shinnipon open-field autorefractor. Secondary outcome measures were the changes in accommodative amplitude and monocular accommodative facility. Results. All participants completed the study. The lag of accommodation at baseline visit was 1.29 ± 0.21 D and it was reduced to 0.84 ± 0.19 D at 12-week visit. This difference (−0.46 ± 0.22 D; 95% confidence interval: −0.33 to −0.58 D) is statistically significant (p < 0.0001). OBAVT also increased the amplitude and facility by 3.66 ± 3.36 D (p = 0.0013; 95% confidence interval: 1.72 to 5.60 D) and 10.9 ± 4.8 cpm (p < 0.0001; 95% confidence interval: 8.1 to 13.6 cpm), respectively. Conclusion. Standardized 12 weeks of OBAVT with home reinforcement is able to significantly reduce monocular lag of accommodation and increase monocular accommodative amplitude and facility. A randomized clinical trial designed to investigate the effect of vision therapy on myopia progression is warranted.

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Accommodative Facility in Eyes with and without Myopia

Abstract: Myopic eyes have reduced accommodative facility at distance, and accommodative responsiveness to both positive and negative defocus is slow. However, accommodative facility as a test does not have sufficient power to discriminate eyes with myopia from other refractive errors.

Cited by 38 publications

References 36 publications

Accommodative Training to Reduce Nearwork-Induced Transient Myopia

Accommodative Training to Reduce Nearwork-Induced Transient Myopia

Change in choroidal thickness and the relationship with accommodation following myopic excimer laser surgery

Effect of Vision Therapy on Accommodation in Myopic Chinese Children

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