Binocular accommodation reaction and response times for normal observers

Wavefront sensing: A breakthrough for objective evaluation of dynamic accommodation in accommodative dysfunctions

The purpose of this study was to use wavefront sensing as an objective method to detect and assess dynamic accommodation in subjects with accommodative dysfunctions and symptoms related to near-vision tasks. Sixty-three subjects were divided into control (N = 18), symptomatic without any accommodative dysfunction (SWD) (N = 18), infacility of accommodation (INFA) (N = 6), excess of accommodation (EA) (N = 9), and insufficiency of accommodation (INSA) (N = 12) groups. Accommodation was stimulated in different cycles of accommodation and disaccommodation while ocular aberrations were measured. Dynamic accommodation was computed from ocular wavefront aberrations and then analysed, including response time, peak velocity, and microfluctuations. Subjects with accommodative dysfunctions showed alterations in accommodative responses compared to the control group, characterized by slower and excessive/reduced responses, as well as an increase in accommodative microfluctuations and difficulty in relaxing accommodation to different accommodative demands. The SWD group showed significant changes compared to the control group, suggesting accommodative problems not previously detected in clinical examinations and explaining the symptoms reported by these subjects. The specific patterns of the characteristics of dynamic accommodation are presented for the different accommodative dysfunctions. The objective assessment of dynamic accommodation using wavefront sensing, analysed for different accommodative demands, provides a comprehensive approach to the detection and characterisation of accommodative dysfunctions. This method enables the improvement of the precision of the diagnosis of accommodative dysfunctions and allows its detection in cases that may not be detected by current clinical examinations. In addition, this method may contribute to personalized treatment planning, potentially improving patient outcomes in clinical practice.

Using a video-based eye tracker to analyse the binocular near-reflex dynamics response

PURPOSE

This study presents a novel video-based eye-tracking system for analysing the dynamics of the binocular near-reflex response. The system enables the simultaneous measurement of convergence, divergence and pupillary size during accommodation and disaccommodation to aid the comprehensive understanding of the three-component near-reflex.

METHODS

A high-speed (90 Hz) video-based eye tracker was used to capture changes in eye gaze and pupil radius in 15 participants in response to altering stimulus conditions. An offline analysis involved separating the gaze vector components and pupil radius, which were fitted to a hyperbolic tangent function to characterise the dynamics of the near-reflex process.

RESULTS

Significant differences in the temporal parameters of the pupil radius were observed between the near-to-far and far-to-near vision changes, with faster miosis compared with mydriasis. Additionally, differences in response times were found between gaze angle components, with longer convergence times compared to changes in the vertical direction (saccades). The steady-state values of the gaze components and pupil radius were in line with theoretical expectations and previous reports.

CONCLUSIONS

The proposed system provides a non-invasive, portable and cost-effective method for evaluating near-reflex dynamics under natural viewing conditions using a video-based eye tracker. The sampling rate ensures the accurate assessment of vergence eye movements and pupillary dynamics. By simultaneously measuring eye convergence, divergence and pupil size, the system offers a more comprehensive assessment of the near-reflex response. This makes it a valuable tool for clinical diagnosis, research studies and investigating the effects of near work on the visual system.

The Effect of Context Switching, Focal Switching Distance, Binocular and Monocular Viewing, and Transient Focal Blur on Human Performance in Optical See-Through Augmented Reality

In optical see-through augmented reality (AR), information is often distributed between real and virtual contexts, and often appears at different distances from the user. To integrate information, users must repeatedly switch context and change focal distance. If the user's task is conducted under time pressure, they may attempt to integrate information while their eye is still changing focal distance, a phenomenon we term transient focal blur. Previously, Gabbard, Mehra, and Swan (2018) examined these issues, using a text-based visual search task on a one-eye optical see-through AR display. This paper reports an experiment that partially replicates and extends this task on a custom-built AR Haploscope. The experiment examined the effects of context switching, focal switching distance, binocular and monocular viewing, and transient focal blur on task performance and eye fatigue. Context switching increased eye fatigue but did not decrease performance. Increasing focal switching distance increased eye fatigue and decreased performance. Monocular viewing also increased eye fatigue and decreased performance. The transient focal blur effect resulted in additional performance decrements, and is an addition to knowledge about AR user interface design issues.

Monocular accommodation response to random defocus changes induced by a tuneable lens

Accommodation of the human eye relies on multiple factors and visual cues that include object size, monochromatic and chromatic aberrations, and vergence. Yet, even in monocular conditions, accommodation corrects for defocus. Studies of eye growth in chicks have addressed whether the retina can decode the sign of defocus as this may play a role for emmetropization and possibly also accommodation. However, findings have not been unambiguous and questions remain. Here, we report on monocular accommodation studies of emmetropic and myopic human subjects to clarify whether foveal vision drives accommodation in the correct direction by removing out-of-focus blur potentially before relying on other cues. Subjects viewed monocularly a green target at 1-meter distance while being presented with a random sequence of negative defocus step changes induced by a pupil-conjugated current-driven tuneable lens. The natural pupil was constricted by a pupil-conjugated motorized iris using three different diameters and target brightness was set with a liquid crystal variable attenuator. A Hartmann-Shack wavefront sensor with an infrared beacon captured real-time changes of defocus and Zernike polynomial coefficients up to 4th radial order. We find that the young adult eye accommodates reliably in the correct direction but with a latency of 300-700 ms. The findings are discussed in relation to an absorption model of light in outer segments that breaks the defocus symmetry and thus may serve as a plausible guide for accommodation and emmetropization.

Adaptive eyeglasses for presbyopia correction: an original variable-focus technology

We propose an original variable-focus technology specially designed for presbyopia-correcting adaptive eyeglasses. It has been thought through to offer vision comfort without cutting on aesthetics. It relies on a fluid-filled variable-focus lens (presenting 2 liquids and 1 ultra-thin membrane) assisted by a low-power, high-volume microfluidic actuator. It also features a distance-sensing system to provide automatic focusing. We demonstrate the qualities of this novel technology on our first prototype. Our prototype achieves the necessary 3-diopter-high power variation on a 20-millimeter-wide variable zone with low actuation pressures (~200 Pa at most), and the preliminary optical quality analysis shows the spatial resolution is much better than the one specified by classic eye charts. We discuss further improvements in terms of optics, aesthetics and portability. In particular, we point out that this variable technology is compatible with standard base curves, and we highlight an optimal configuration where the power consumption of our opto-fluidic engine is about 25 mW peak.

Is 25Hz enough to accurately measure a dynamic change in the ocular accommodation?

BACKGROUND

Accommodation is often recorded at a low sampling rate using devices such as autorefractors that are designed to measure the static refractive error. It is therefore important to determine if that resolution is sufficient to accurately measure the dynamic properties of accommodation. The current study provides both theoretical and empirical evidence on the ideal sampling rate necessary to measure a dynamic response.

METHODS

Accommodative and disaccommodative step stimuli ranging from 1-3D (1D steps) were presented using a Badal optical system. Responses from 12 children (8-13 years) and 6 adults (20-35 years) were recorded using a dynamic photorefractor (DPR). Fast Fourier transformation was applied to the unsmoothed dynamic responses including position, velocity and acceleration. Also, velocity and acceleration main sequence (MS) characteristics were compared between three photorefractor conditions on 3 subjects.

RESULTS

The Nyquist sampling limit necessary to accurately estimate position, velocity and acceleration was at least 5, 10 and 70Hz, respectively. Peak velocity and acceleration were significantly underestimated at a lower rate (p<0.5). However, the slope of MS remained invariant with sampling rate (p>0.5).

CONCLUSION

Contrary to the previous findings, a dynamic accommodative response exhibited frequencies larger than 10Hz. Stimulus direction and amplitude had no influence on the frequencies present in the dynamic response. Peak velocity and acceleration can be significantly underestimated when sampled at a lower rate. Taken as a whole, low sampling rate instruments can accurately estimate static accommodation, however, caution needs to be exercised when using them for dynamic accommodation.

Achromatic doublet intraocular lens for full aberration correction

A doublet intraocular lens optimized for both chromatic and monochromatic aberration correction in pseudophakic eyes is presented. Ray-tracing techniques were applied to design the lens in white light within a chromatic eye model. Combinations of two materials, already commonly used in intraocular lenses, as acrylic and silicone, were used. Iterative optimization algorithms were employed to correct for longitudinal chromatic aberration, spherical aberration and off-axis aberrations within 10 degrees of visual field. The performance of this lens was compared with a standard single-material aspheric intraocular lens. Near full aberration correction was achieved with the doublet intraocular lens. The modulation transfer function and Strehl ratio were superior for the doublet lens. Through-focus calculations were also conducted showing better optical quality for the doublet. Real higher-order aberrations from normal eyes were incorporated in the model to evaluate the effect on the doublet intraocular lens performance. Results showed that the doublet lens preserved its benefits under realistic conditions. This doublet intraocular lens should provide patients with a better quality of vision after it is further developed in terms of manufacturing and surgical limitations.

Does transient increase in axial length during accommodation attenuate with age?

Background

The aim was to profile transient accommodative axial length changes from early adulthood to advanced presbyopia and to determine whether any differences exist between the responses of myopic and emmetropic individuals.

Methods

Ocular biometry was measured by the LenStar biometer (Haag‐Streit, Switzerland) in response to zero, 3.00 and 4.50 D accommodative stimuli in 35 emmetropes and 37 myopes, aged 18 to 60 years. All results were corrected to reduce errors arising from the increase in crystalline lens thickness with accommodation. Accommodative responses were measured sequentially by the WAM 5500 Auto Ref/Keratometer (Grand Seiko, Hiroshima, Japan).

Results

Axial length increased significantly with accommodation (p < 0.001), with a mean corrected increase in axial length of 2 ± 18 µm and 8 ± 16 µm observed at 3.00 and 4.50 D, respectively. The magnitude of accommodative change in axial length was not dependent on refractive error classification (p = 0.959); however, a significant reduction in the magnitude and variance of axial length change was evident after 43 to 44 years of age (p < 0.002).

Conclusion

The negative association between transient increase in axial length and age, in combination with reduced variance of data after age 43 to 44 years, is consistent with a significant increase in posterior ocular rigidity, which may be influential in the development of presbyopia.

The short-term accommodation response to aniso-accommodative stimuli in isometropia

PURPOSE

There have been only a limited number of studies examining the accommodative response that occurs when the two eyes are provided with disparate accommodative stimuli, and the results from these studies to date have been equivocal. In this study, we therefore aimed to examine the capacity of the visual system to aniso-accommodate by objectively measuring the interocular difference in the accommodation response between fellow dominant and non-dominant eyes under controlled monocular and binocular viewing conditions during short-term exposure to aniso-accommodative stimuli.

METHODS

The accommodative response of each eye of 16 young isometropic adults (mean age 22 ± 2 years) with normal binocular vision was measured using an open-field autorefractor during a range of testing conditions; monocularly (accommodative demands ranging from 1.97 to 2.90 D) and binocularly while altering the accommodation demand for each eye (aniso-accommodative stimuli ranging from 0.08 to 0.53 D) [Corrected].

RESULTS

Under monocular viewing conditions, the dominant and non-dominant eyes displayed a highly symmetric accommodative response; mean interocular difference in spherical equivalent 0.01 ± 0.06 D (relative) and 0.22 ± 0.06 D (absolute) (p > 0.05). During binocular viewing, the dominant eye displayed a greater accommodative response (0.11 ± 0.34 D relative and 0.24 ± 0.26 D absolute) irrespective of whether the demand of the dominant or non-dominant eye was altered (p = 0.01). Astigmatic power vectors J0 and J45 did not vary between eyes or with increasing accommodation demands under monocular or binocular viewing conditions (p > 0.05).

CONCLUSION

The dominant and non-dominant eyes of young isometropic individuals display a similar consensual lag of accommodation under both monocular and binocular viewing conditions, with the dominant eye showing a small but significantly greater (by 0.12-0.25 D) accommodative response. Evidence of short-term aniso-accommodation in response to asymmetric accommodation demands was not observed.

Adaptive Optics for Visual Simulation

A revision of the current state-of-the-art adaptive optics technology for visual sciences is provided. The human eye, as an optical system able to generate images onto the retina, exhibits optical aberrations. Those are continuously changing with time, and they are different for every subject. Adaptive optics is the technology permitting the manipulation of the aberrations, and eventually their correction. Across the different applications of adaptive optics, the current paper focuses on visual simulation. These systems are capable of manipulating the ocular aberrations and simultaneous visual testing though the modified aberrations on real eyes. Some applications of the visual simulators presented in this work are the study of the neural adaptation to the aberrations, the influence of aberrations on accommodation, and the recent development of binocular adaptive optics visual simulators allowing the study of stereopsis.

Accommodative response to peripheral stimuli in myopes and emmetropes

PURPOSE

It has been suggested that peripheral refractive error may influence eye growth and the development of axial refractive error, implying that the peripheral retina is sensitive to defocus. This study aimed to evaluate the steady-state accommodative response to peripheral stimuli in 10 young, adult myopes (mean spherical equivalent error -2.10 ± 1.72 D, median -1.63 D, range -0.83 to -6.00 D) and 10 emmetropes (mean spherical equivalent error -0.02 ± 0.35 D, median +0.08 D, range -0.50 to +0.50 D).

METHODS

The subjects were asked to view monocularly the centre of a screen displaying each of a series of eccentric accommodative targets placed at 5, 10 and 15°. An axial target was viewed for comparison purposes. Accommodation was measured using an open-field autorefractor, each stimulus being varied between about 0 and 4 D with spherical trial lenses placed in front of the viewing eye.

RESULTS

The results confirm that the peripheral retina is sensitive to optical focus, up to field angles of at least 15°, with accommodative responses weakening as the peripheral angle increases. There is some evidence that peripheral accommodation may be less effective in myopes than emmetropes.

CONCLUSIONS

Although peripheral accommodation can be demonstrated in the absence of a central stimulus, the accommodation response is normally dominated by the central stimulus and it seems unlikely that peripheral accommodation effects play an important role in refractive development.

Dynamic accommodation responses following adaptation to defocus

PURPOSE

Adaptation to defocus is known to influence the subjective sensitivity to blur in both emmetropes and myopes. Blur is a major contributing factor in the closed-loop dynamic accommodation response. Previous investigations have examined the magnitude of the accommodation response following blur adaptation. We have investigated whether a period of blur adaptation influences the dynamic accommodation response to step and sinusoidal changes in target vergence.

METHOD

Eighteen subjects (six emmetropes, six early onset myopes, and six late onset myopes) underwent 30 min of adaptation to 0.00 D (control), +1.00 D or +3.00 D myopic defocus. Following this adaptation period, accommodation responses to a 2.00 D step change and 2.00 D sinusoidal change (0.2 Hz) in target vergence were recorded continuously using an autorefractor.

RESULTS

Adaptation to defocus failed to influence accommodation latency times, but did influence response times to a step change in target vergence. Adaptation to both +1.00 and +3.00 D induced significant increases in response times (p = 0.002 and p = 0.012, respectively) and adaptation to +3.00 D increased the change in accommodation response magnitude (p = 0.014) for a 2.00 D step change in demand. Blur adaptation also significantly increased the peak-to-peak phase lag for accommodation responses to a sinusoidally oscillating target, although failed to influence the accommodation gain. These changes in accommodative response were equivalent across all refractive groups.

CONCLUSION

Adaptation to a degraded stimulus causes an increased level of accommodation for dynamic targets moving towards an observer and increases response times and phase lags. It is suggested that the contrast constancy theory may explain these changes in dynamic behavior.

Binocular correlation of ocular aberration dynamics

Fluctuations in accommodation have been shown to be correlated in the two eyes of the same subject. However, the dynamic correlation of higher-order aberrations in the frequency domain has not been studied previously. A binocular Shack-Hartmann wavefront sensor is used to measure the ocular wavefront aberrations concurrently in both eyes of six subjects at a sampling rate of 20.5 Hz. Coherence function analysis shows that the inter-ocular correlation between aberrations depends on subject, Zernike mode and frequency. For each subject, the coherence values are generally low across the resolvable frequency range (mean 0.11), indicating poor dynamic correlation between the aberrations of the two eyes. Further analysis showed that phase consistency dominates the coherence values. Monocular and binocular viewing conditions showed similar power spectral density functions.

Accommodation and vergence latencies in human infants

PURPOSE

Achieving simultaneous single and clear visual experience during postnatal development depends on the temporal relationship between accommodation and vergence, in addition to their accuracies. This study was designed to examine one component of the dynamic relationship, the latencies of the responses.

METHODS

Infants and adults were tested in three conditions (i) binocular viewing of a target moving in depth at 5 cm/s (closed loop) (ii) monocular viewing of the same target (vergence open loop) (iii) binocular viewing of a low spatial frequency Difference of Gaussian target during a prism induced step change in retinal disparity (accommodation open loop).

RESULTS

There was a significant correlation between accommodation and vergence latencies in binocular conditions for infants from 7 to 23 weeks of age. Some of the infants, as young as 7 or 8 weeks, generated adult-like latencies of less than 0.5 s. Latencies in the vergence open loop and accommodation open loop conditions tended to be shorter for the stimulated system than the open loop system in both cases, and all latencies were typically less than 2 s across the infant age range.

CONCLUSIONS

Many infants between 7 and 23 weeks of age were able to generate accommodation and vergence responses with latencies of less than a second in full binocular closed loop conditions. The correlation between the latencies in the two systems suggests that they are limited by related factors from the earliest ages tested.

Human infants' accommodation responses to dynamic stimuli

PURPOSE

A young infant's environment routinely consists of moving objects. The dynamics of the infant accommodative system are almost unknown and yet have a large impact on habitual retinal image quality and visual experience. The goal of this study was to record infants' dynamic accommodative responses to stimuli moving at a range of velocities.

METHODS

Binocular accommodative responses were recorded at 25 Hz. Data from infants 8 to 20 weeks of age and pre-presbyopic adults were analyzed. A high-contrast image of a clown was moved between 20- and 50-cm viewing distances at four velocities (a step, 50 cm/s, 20 cm/s, and 5 cm/s).

RESULTS

Most infants who had clear responses were able to initiate their response within a second of stimulus onset. The infants were able to discriminate the different stimulus velocities and to adjust their response velocities and durations in an appropriate fashion.

CONCLUSIONS

The data indicate that by the third postnatal month infants are able to respond with latencies within a factor of two of adults' and that there is little immaturity in the motor capabilities of the accommodative system compared with the sensory visual system at the same age.

Dynamic control of ocular disaccommodation: first and second-order dynamics

Velocity and acceleration characteristics provide valuable information about dynamic control of accommodation. We investigated velocity and acceleration of disaccommodation (near-far focusing) from three starting positions. Peak velocity and peak acceleration of disaccommodation increased with the proximity of starting position however for a given starting position they were invariant of response magnitude. These results suggest that all disaccommodation responses are initiated towards a constant primary destination and are switched mid-flight to attain the desired final position. Large discrepancies between the primary destination and desired final position appear to produce overshoots and oscillations of small responses from proximal starting positions.

Age related changes in accommodative dynamics in humans

Age related changes in the dynamics of accommodation (far to near focus) and disaccommodation (near to far focus) are reported in this study. Dynamic responses to step stimulus demands from 1D to 6D, in 1D steps, were recorded with a PowerRefractor in 66 subjects in the age range 14-45 years. The accommodative and disaccommodative responses were fit with exponential functions to calculate response amplitude, time constant and peak velocity. The latency of accommodation did not change and the latency of disaccommodation increased with age. For accommodation, time constant increased and peak velocity decreased with age. For disaccommodation, no change in time constant or peak velocity was found with age. The form of the peak velocity vs response amplitude relationship (main sequence) of accommodation changed with age. The differences in the dynamics of accommodation and disaccommodation with age are discussed with reference to the age related changes in the eye leading to presbyopia.

The effect of monocular and binocular viewing on the accommodation response to real targets in emmetropia and myopia

PURPOSE

Decreased blur-sensitivity found in myopia has been linked with reduced accommodation responses and myopigenesis. Although the mechanism for myopia progression remains unclear, it is commonly known that myopic patients rarely report near visual symptoms and are generally very sensitive to small changes in their distance prescription. This experiment investigated the effect of monocular and binocular viewing on static and dynamic accommodation in emmetropes and myopes for real targets to monitor whether inaccuracies in the myopic accommodation response are maintained when a full set of visual cues, including size and disparity, is available.

METHODS

Monocular and binocular steady-state accommodation responses were measured with a Canon R1 autorefractor for target vergences ranging from 0-5 D in emmetropes (EMM), late-onset myopes (LOM), and early-onset myopes (EOM). Dynamic closed-loop accommodation responses for a stationary target at 0.25 m and step stimuli of two different magnitudes were recorded for both monocular and binocular viewing.

RESULTS

All refractive groups showed similar accommodation stimulus response curves consistent with previously published data. Viewing a stationary near target monocularly, LOMs demonstrated slightly larger accommodation microfluctuations compared with EMMs and EOMs; however, this difference was absent under binocular viewing conditions. Dynamic accommodation step responses revealed significantly (p < 0.05) longer response times for the myopic subject groups for a number of step stimuli. No significant difference in either reaction time or the number of correct responses for a given number of step-vergence changes was found between the myopic groups and EMMs.

CONCLUSION

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.

Acceleration characteristics of human ocular accommodation

Position and velocity of accommodation are known to increase with stimulus magnitude, however, little is known about acceleration properties. We investigated three acceleration properties: peak acceleration, time-to-peak acceleration and total duration of acceleration to step changes in defocus. Peak velocity and total duration of acceleration increased with response magnitude. Peak acceleration and time-to-peak acceleration remained independent of response magnitude. Independent first-order and second-order dynamic components of accommodation demonstrate that neural control of accommodation has an initial open-loop component that is independent of response magnitude and a closed-loop component that increases with response magnitude.

Accommodation as a function of age and the linearity of the response dynamics

The changes with age in the accommodation responses to dynamic stimuli can reveal useful information on the factors underlying presbyopia development. Analysis of the monocular accommodation responses of 19 normal observers (ages 18-49 years) to stimuli whose vergence varied sinusoidally with time at different temporal frequencies (peak-to-peak stimulus 1.33-2.38 D, at 0.05-1.00 Hz) showed that at all ages both the gain and phase of the response were essentially linear functions of the temporal frequency. Extrapolation of least-squares, regression line fits to the gain data for each subject gave the gain at zero frequency, G0, and the cut-off frequency, fc, at which the gain fell to zero. G0 reduced with age but fc remained essentially constant at about 1.7 Hz, up to at least the age of about 40. The magnitude of the response to step stimuli covering the same stimulus range was well correlated with the value of G0. The linear changes in phase lag with temporal frequency corresponded to simple time delays td. The time lag varied from close to zero for the youngest subjects to about 0.5 s for the subjects in their late forties. There was substantial variation between the responses of subjects of similar age: those subjects with high values of G0 also tended to have low values of td, both effects probably being due to the superior ability of some individuals to predict the sinusoidal changes in the accommodation stimulus. Comparison of theoretical step responses, derived by applying linear theory to the parameters obtained from the results for the sinusoidal stimuli, with the actual responses to unpredictable steps for the same subjects supports the view that prediction effects and other possible factors make linear theory inapplicable to this type of data. The results are discussed in the context of current ideas on the development of presbyopia: it is suggested that the constancy of fc with age is the result of the ciliary body maintaining its efficiency, whereas the fall in G0 and increase in td result from increases in lens rigidity.

Aniso-accommodation as a possible factor in myopia development

It is shown that the asymmetric convergence caused by the changes in fixation required to read a line of text results in unequal accommodation demands to the two eyes. Since experimental evidence suggests that the required aniso-accommodation response cannot be achieved, and that accommodation in both eyes tends to match the response to the lower of the two demands, in general the retinal image in at least one eye must be out-of-focus. The resultant blur increases as the eccentricity of gaze is increased and the reading distance is reduced, and also depends on the posture and position of the head, together with the balance between eye and head movements. By analogy with the results of animal experiments, it is argued that the defocused retinal imagery involved in reading and similar tasks could be a factor in myopia development, particularly in children who adopt unfavourable reading postures.

Amplitude dependent accommodative dynamics in humans

Dynamics of accommodation (far-to-near focus) and disaccommodation (near-to-far focus) are described as a function of response amplitude. Accommodative responses to step stimuli of various amplitudes presented in real space were measured in eight 20-30 year old subjects. Responses were fitted with exponential functions to determine amplitude, time constant and peak velocity. Despite the intersubject variability, the results show that time constants of accommodation and peak velocity of disaccommodation increase with amplitude in all subjects. The dynamics of accommodation and disaccommodation are dependent on amplitude, but have different properties in each case.

Accommodation dynamics as a function of age

Experiments are described in which the dynamic accommodation response to a stimulus whose vergence was varying sinusoidally with time between 1.33 and 2.38 D was measured as a function of frequency for 19 subjects, with ages distributed between 18 and 49 years. Response to abrupt stimulus change between the same levels was also measured. The results showed that at any age, for the sinusoidal stimuli, gain fell with frequency and phase lag increased: at fixed frequency, gain fell with age and phase lag increased. Neither reaction nor response times for step stimuli changed with age. Analysis of the sinusoidal data suggests the possible existence of a cut-off frequency of about 2 Hz, which varies little with age and above which the system cannot respond. The phase data is compatible with the existence of a frequency-independent time delay, which increases with age from about 0.17 s at 20 years to 0.48 s at 40 years. The results are discussed in terms of current knowledge of the factors contributing to the development of presbyopia.

Continuous measurement of accommodation in human factor applications

It has long been sought to measure ocular accommodation continuously in human factor applications such as driving or flying. Open-field autorefractors such as the Canon R-1 could be converted to allow continuous, objective recording, but steady eye fixation and head immobilisation were essential for the measurements to be valid. Image analysis techniques utilised by newer open-view autorefractors such as the Shin-Nippon SRW-5000 are more tolerant to head and eye movements, but perhaps the technique with the greatest potential for the measurement of accommodation in human factor applications is photoretinoscopy. This paper examines the development of techniques for high temporal measurements of accommodation and reports on the tolerance of one such recent commercial instrument, the PowerRefractor (PlusOptiX). The instrument was found to be tolerant to eye movements from the optical axis of the instrument (approximately 0.50 DS change in apparent accommodation with gaze 25 degrees eccentric to the optical axis), longitudinal head movement (<0.25 DS from 8 cm towards and 20 cm away from the correct photorefractor to eye distance) and changes in background illuminance (<0.25 DS from 0.5 to 20 cd m(-2) target luminance). The PowerRefractor also quantifies the direction of gaze and pupil size, but is unable to take measurements with small pupils <3.7 +/- 1.0 mm.

Effect of beta-adrenoceptor antagonists on autonomic control of ciliary smooth muscle

PURPOSE

Pharmacological intervention with peripheral sympathetic transmission at ciliary smooth muscle neuro-receptor junctions has been used against a background of controlled parasympathetic activity to investigate the characteristics of autonomic control of ocular accommodation.

METHODS

A continuously recording infra-red optometer was used to measure accommodation on a group of five visually normal emmetropic subjects under open- and closed-loop conditions. A double-blind protocol between saline, timolol and betaxolol was used to differentiate between the localised action on ciliary smooth muscle and effects induced by changes in stimulus conditions. Data were collected before and 45 min following the instillation of saline, timolol or betaxolol. Open-loop post-task decay was investigated following 3 min sustained near fixation of a stimulus placed 3 D above the subject's pre-task tonic accommodation level. Closed-loop dynamic responses were recorded for each treatment condition while subjects viewed sinusoidally (0.05-0.6 Hz) or stepwise vergence-modulated targets over a 2 D range (2-4 D).

RESULTS

Open-loop data demonstrate a rapid post-task regression to pre-task tonic accommodation levels for saline and betaxolol control conditions. A slow positive post-task shift was induced by timolol indicating that sympathetic inhibition contributes to accommodative adaptation during sustained near vision. Closed-loop accommodation responses to temporally modulated sinusoidal stimuli showed characteristic features for both saline and betaxolol control conditions. Timolol induced a reduced gain for low- and mid-temporal frequencies (< 0.3 Hz) but did not affect the response at higher temporal frequencies. Response times to stepwise stimuli increased following the instillation of timolol for the near-to-far fixation condition compared with the controls and was related to the period of sustained prior fixation.

CONCLUSIONS

Modulation of accommodation under open- and closed-loop conditions by a non-selective beta-blocker is consistent with the temporal and inhibitory features of sympathetic innervation to ciliary smooth muscle. Although parasympathetic innervation predominates there is evidence to support a role for sympathetic innervation in the control of ocular accommodation.

Age changes in the interactions between the accommodation and vergence systems

Experiments are described in which static and dynamic accommodation (Ar), accommodative convergence (AC), vergence (C) and convergence accommodation (CA) responses to small stimuli were measured dynamically in 13 subjects with ages in the range 16 to 48 years. Analysis showed that the amplitudes of both blur and disparity-driven accommodation declined significantly with age, whereas the two types of vergence response did not. As a result, the AC/Ar ratio rose significantly with age, whereas the CA/C ratio fell. No significant change with age was found in response latencies and durations.

Dynamics of the accommodation response to abrupt changes in target vergence as a function of age

The dynamic accommodation responses to small, abrupt changes in an accommodation stimulus were studied in two experiments. In the first, responses of 19 subjects with ages distributed between 18 and 49 years were measured for step stimuli of +/- 1.05 D. In the second, responses to small step stimuli (+/- 0.75, +/- 1.75 D) were recorded for a group of six 'young' (mean age 22, range 16-26 years) and six 'old' (mean age 42, range 36-48 years) subjects. In both experiments, the low target vergences always lay within the accommodation range of all subjects. Whether the data were analysed in terms of simple reaction and response times, or in terms of the frequency response, no marked systematic changes with age were found in the dynamics of the response in either of the experiments. It is concluded that, for small stimuli within the amplitude of accommodation, the response dynamics over the adult age range studied remain remarkably constant, even though the amplitude progressively reduces with age as complete presbyopia is approached.

Subjective measurement of the near point of accommodation in pre/early literates

PURPOSE

This study was undertaken to develop a tool and acquire data on subjective accommodation measurements in young children. Previously, subjective measurements of accommodation in children has been assessed with tools requiring literacy or reliable reporting of a blur point with the standard lower age limit of eight years. It was our belief that younger children could yield reliable subjective accommodation measurements given an age appropriate tool.

METHOD

We devised a tool (modified tape measure using preliterate symbols) which was compared to our gold standard tool (RAF rule). These tools were compared in a literate group of subjects (N = 34) to assess agreement between the two devises. The modified tape measure was also tested on a pre/early literate group of subjects (N = 51) to assess their ability to respond consistently and to acquire data on subjective accommodation values for children ages three to seven.

RESULTS

Literate group-Agreement between the two devises was good with concordance correlation coefficient values of 84 for the right eye and .87 for the left eyes. Greater than .87% of responses for both devices differed by two centimeters or less. Based on the nature of these types of subjective accommodation tests, agreement of within two centimeters indicates good clinical reliability. Pre/ Early Literate group-For the purposes of statistical analysis, the three year olds were not included due to low numbers (N = 5). The four/five year olds (N = 29) and six/seven year olds (N = 17) formed two subgroups for statistical analysis. T test results indicated no significant difference in accommodation amplitudes between a 4-5 year old and 6-7 year subgroups. Evaluation of the best two out of three responses in this group indicated good reliability for most subjects. As a group the mean subjective accommodation amplitude was 9.1 centimeters with a standard deviation of 2.3 centimeters.

CONCLUSION

The new tool appears to be safe, effective, acceptable to young children, and comparable to our current tool used for older age groups.

On the linearity of accommodation dynamics

Available experimental data on the gain and phase lags in the closed-loop accommodation responses to stimuli whose dioptric vergence changes sinusoidally with time are examined. It is shown that both phase lags and gain change almost linearly with the temporal frequency of the stimulus. This implies that the phase lags correspond to a frequency-independent time delay and that, if the system is linear, the impulse response should take a symmetrical (sin x/x)(2) form, with a corresponding standard form of step response. Comparison of this derived step response with the quasi-exponential results found experimentally underlines the limitations of attempting to generalize dynamic accommodation performance from responses obtained with predictable sinusoidally-changing stimuli and the application of a linear model. Consideration of the frequency response which would lead to an exponential step response supports the argument that, although the gain results obtained with sinusoidal stimuli are reasonably representative of those applying with other forms of stimulus, the predictable nature of sinusoidally-changing stimuli makes the derived phase lags inapplicable to non-predictable step or other stimuli. Other limitations in linear models of the response are discussed.

Accommodation causes with-the-rule astigmatism in emmetropes

PURPOSE

To measure the changes in astigmatism when bilateral emmetropes accommodate.

METHODS

Bilateral emmetropes accommodative responses were measured with an improved photorefractometer PR-1100, which measured binocular refraction in all meridians simultaneously as a fixation target was shown in natural space.

RESULTS

The accommodative responses in the vertical meridian are greater than those in the horizontal meridian. In the horizontal meridian, the accommodative responses are less than the accommodative stimulus.

CONCLUSIONS

When accommodating the majority of bilateral emmetropes show with-the-rule astigmatism and lag of accommodation in the horizontal meridian.

Evolution of control system models of ocular accommodation, vergence and their interaction

This paper reviews the evolution of inferential models describing ocular accommodation and vergence, which have been developed using the techniques of control engineering. The models are developed by inferring that the observed behaviour of the ocular systems could be produced by particular types of feedback control systems. The models are subsequently tested and improved by modifications resulting from the comparison of model predictions with physiological experimentation. Current models of accommodation and vergence have had considerable success in describing both the steady-state and dynamic behaviours of the individual systems. However, controversy currently exists among researchers, particularly with respect to the composition of models that describe the interaction of the two systems.

Accommodative microfluctuations and pupil diameter

The nominally steady-state accommodation response exhibits temporal variations which can be characterized by two dominant regions of activity; a low frequency component (LFC < 0.6 Hz) and a high frequency component (1.0 < or = HFC < or = 2.1 Hz). There is no consensus as to the relative contribution made by each of the frequency components of the microfluctuations to the control of steady-state accommodation. We investigate the effect of variations in artificial pupil diameter (0.5, 1, 2, 3, 4 and 5 mm pupils) on the microfluctuations of accommodation, while three young emmetropic subjects view, monocularly, a photopic high contrast Maltese cross target placed at a dioptric distance equal to their open-loop accommodation level. Average power spectra were calculated for five accommodation signals, each of 10 sec duration, collected for each viewing condition at a sampling rate of 102.4 Hz using a continuously recording infrared objective optometer. For artificial pupil diameters < or = 2 mm the power of the LFC was found to increase as a function of reducing pupil diameter, while for artificial pupil diameters > 2 mm the LFC was found to be relatively constant. No systematic change in the HFC with varying artificial pupil diameter was observed. Changes in the root-mean-square (r.m.s.) value of the fluctuations with varying pupil diameter were significant (one-way ANOVA, F = 8.507, P = 0.0001, d.f. = 89) and showed a similar form to the changes in the LFC.(ABSTRACT TRUNCATED AT 250 WORDS)

Binocular infrared optometer for measuring accommodation in both eyes simultaneously in natural-viewing conditions

A binocular IR optometer has been developed to measure accommodation continuously and simultaneously in both human eyes in conditions close to natural viewing where a subject gazes at an actual target with binocular vision. Measurement accuracy is ~ 0.24 D with a precision of 0.05 D within a refractive-power range of + 10 to -10 D in model eyes. The dynamic response is over 100 D/s. In addition we measured simultaneously and continuously accommodation, pupil diameter, and eye position of both human eyes in near-reflex conditons using this binocular optometer. Development of the tracking IR binocular optometer is discussed in detail.