Effect of even and odd-order aberrations on the accommodation response.

AIM: To investigate the potential effect that odd and even-order monochromatic aberrations may have on the accommodation response of the human eye. METHODS: Eight healthy subjects with astigmatism below 1 D, best corrected visual acuity 20/20 or better and normal findings in an ophthalmic examination were enrolled. An adaptive optics system was used in order to measure the accommodation response of the subjects' eyes under different conditions: with the natural aberrations being present, and with the odd and even-order aberrations being corrected. Three measurements of accommodation response were monocularly acquired at accommodation demands ranging from 0 to 4 D (0.5 D step). RESULTS: The accommodative lag was greater for the accommodative demands of 1.5, 3, 3.5 and 4 D for the condition in which the even-order aberrations were corrected, in comparison to that obtained for the natural aberrations and corrected odd-order aberrations for the same accommodation demands. No statistically significant differences were found between the accommodation responses under the three conditions. CONCLUSION: The odd and even-order aberrations are not helping the visual system to accommodate, because their partial correction do not affect the accommodation performance

Assessing the accommodation response after near visual tasks using different handheld electronic devices

ABSTRACT Purpose: To assess the accommodation response after short reading periods using a tablet and a smartphone as well as determine potential differences in the accommodation response at various stimulus vergences using a Hartmann- Shack aberrometer. Methods: Eighteen healthy subjects with astigmatism of less than 1 D, corrected visual acuity of 20/20 or better, and normal findings in an ophthalmic examination were enrolled. Accommodation responses were obtained under three different conditions: accommodation system of the eye relaxed and visually stressed with a tablet and an smartphone for 10 min, at a distance of 0.25 m from the subject's eyes. Three measurements of accommodation response were monocularly acquired at stimulus vergences ranging from 0 to 4 D (1-D step). Results: No statistically significant differences were found in the accommodation responses among the conditions. A moderate but gradually increasing root mean square, coma-like aberration was found for every condition. Conversely, the spherical aberration decreased as stimulus vergences increased. These outcomes were identified in comparison to the one-to-one ideal accommodation response, implying that a certain lag value was present in all stimulus vergences different from 0 D. Conclusions: The results support the hypothesis that the difference between the ideal and real accommodation responses is mainly attributed to parameters associated with the accommodation process, such as the near visual acuity, depth of focus, pupil diameter, and wavefront aberrations. The wavefront aberrations were dependent on the 3-mm pupil size selected in this study. The accommoda tion response was not dependent on the electronic device employed in each condition, and it was mainly associated with young age and level of amplitude of accommodation of the subjects

Objective assessment of the effect of pupil size upon the power distribution of multifocal contact lenses.

AIM: To analytically assess the effect of pupil size upon the refractive power distributions of different designs of multifocal contact lenses. METHODS: Two multifocal contact lenses of center-near design and one multifocal contact lens of center-distance design were used in this study. Their power profiles were measured using the NIMO TR1504 device (LAMBDA-X, Belgium). Based on their power profiles, the power distribution was assessed as a function of pupil size. For the high addition lenses, the resulting refractive power as a function of viewing distance (far, intermediate, and near) and pupil size was also analyzed. RESULTS: The power distribution of the lenses was affected by pupil size differently. One of the lenses showed a significant spread in refractive power distribution, from about -3 D to 0 D. Generally, the power distribution of the lenses expanded as the pupil diameter became greater. The surface of the lens dedicated for each distance varied substantially with the design of the lens. CONCLUSION: In an experimental basis, our results show how the lenses power distribution is affected by the pupil size and underlined the necessity of careful evaluation of the patient's visual needs and the optical properties of a multifocal contact lens for achieving the optimal visual outcome

Amplitude, Latency, and Peak Velocity in Accommodation and Disaccommodation Dynamics.

The aim of this work was to ascertain whether there are differences in amplitude, latency, and peak velocity of accommodation and disaccommodation responses when different analysis strategies are used to compute them, such as fitting different functions to the responses or for smoothing them prior to computing the parameters. Accommodation and disaccommodation responses from four subjects to pulse changes in demand were recorded by means of aberrometry. Three different strategies were followed to analyze such responses: fitting an exponential function to the experimental data; fitting a Boltzmann sigmoid function to the data; and smoothing the data. Amplitude, latency, and peak velocity of the responses were extracted. Significant differences were found between the peak velocity in accommodation computed by fitting an exponential function and smoothing the experimental data (mean difference 2.36 D/s). Regarding disaccommodation, significant differences were found between latency and peak velocity, calculated with the two same strategies (mean difference of 0.15 s and -3.56 D/s, resp.). The strategy used to analyze accommodation and disaccommodation responses seems to affect the parameters that describe accommodation and disaccommodation dynamics. These results highlight the importance of choosing the most adequate analysis strategy in each individual to obtain the parameters that characterize accommodation and disaccommodation dynamics

Evaluation of the iridocorneal angle with accommodation using optical coherence tomography.

The changes in the iridocorneal angle structure during accommodation are assessed by means of anterior segment optical coherence tomography. Thirteen right eyes were included in the study. The device used for the measurement was the Visante®omni system. The stimuli were set up at different vergences (0.0 D, -1.5 D, and -3.0 D). The angle opening distance 500 and 750, the trabecular iris space area 500 and 750, and the scleral spur angle parameters were assessed at the nasal and temporal regions. The results in the iridotrabecular angle comparing the three accommodative states of the eye did not yield any statistically significant difference at nasal or temporal angle sections. In light of our results and in the conditions of our study, the structures of the iridocorneal angle are not significantly changed with accommodation

Catástrofes. Repercusión en Salud Mental.

Sin resumen

Catástrofes. Repercusión en Salud Mental.

Sin resumen

Effect of Phenylephrine on the Accommodative System.

Accommodation is controlled by the action of the ciliary muscle and mediated primarily by parasympathetic input through postganglionic fibers that originate from neurons in the ciliary and pterygopalatine ganglia. During accommodation the pupil constricts to increase the depth of focus of the eye and improve retinal image quality. Researchers have traditionally faced the challenge of measuring the accommodative properties of the eye through a small pupil and thus have relied on pharmacological agents to dilate the pupil. Achieving pupil dilation (mydriasis) without affecting the accommodative ability of the eye (cycloplegia) could be useful in many clinical and research contexts. Phenylephrine hydrochloride (PHCl) is a sympathomimetic agent that is used clinically to dilate the pupil. Nevertheless, first investigations suggested some loss of functional accommodation in the human eye after PHCl instillation. Subsequent studies, based on different measurement procedures, obtained contradictory conclusions, causing therefore an unexpected controversy that has been spread almost to the present days. This manuscript reviews and summarizes the main research studies that have been performed to analyze the effect of PHCl on the accommodative system and provides clear conclusions that could help clinicians know the real effects of PHCl on the accommodative system of the human eye