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PubMed1987

Presbyopia: an animal model and experimental approaches for the study of the mechanism of accommodation and ocular ageing.

During the last hundred years, observations on normal and a few aniridic human eyes, together with population studies on the age-dependent decline in accommodative amplitude, resulted in the formulation of theories of human accommodation, and led to the concept that presbyopia is an inevitable consequence of ageing. However, such studies failed to substantiate these theories and concepts or to reveal the fundamental mechanisms of accommodation and its age-dependent loss. Detailed understanding of these mechanisms and the environmental, dietary, and behavioural factors that may influence the development of presbyopia will require controlled studies and, in some cases, invasive experimental manipulations that can only be achieved through the use of an animal model. This paper reviews some of the evidence indicating that the rhesus monkey is a highly suitable primary animal model for such studies, as well as for studies on other aspects of ocular ageing, and reviews some of the techniques and experimental approaches that have already been adapted or developed for such studies.

Accommodation, Ocular↗
PubMed1993

A biometric study of ocular changes during accommodation.

We performed a biometric study that used A-mode ultrasonography on 106 subjects during ocular accommodation. The subjects were divided into two groups; group 1 included 76 subjects and group 2 included 30 subjects. In group 1, we measured the anterior chamber depth, lens thickness, and axial length in the right eye while the left eye, wearing corrective spectacles, focused at distances of 6 m, 33 cm, and 33 cm with an additional correction of +3.0 diopters to offset any accommodative effect. In group 2, we measured the anterior chamber depth, lens thickness, and axial length in the right eye while the left eye focused at distances of 6 m, 33 cm, and 12.5 cm. Similar to the left eyes in group 1, the left eyes in group 2 wore corrective spectacles during all procedures. During accommodation, decreased anterior chamber depth and thickening of the lens were noted in all cases. In group 1, axial length significantly increased an average of 0.06 +/- 0.01 mm (P < .0005) while the left eye focused at a distance of 33 cm. There were no significant changes with the additional +3.0 diopters (P < .05). In group 2, axial length significantly increased an average of 0.05 +/- 0.01 mm (P < .0005) when the left eye focused at a distance of 33 cm, and there was further significant elongation of 0.05 +/- 0.01 mm when the left eye focused at a distance of 12.5 cm. Collectively, these results suggest that axial length increases along with changes in the lens and anterior chamber depth during ocular accommodation.

Accommodation, Ocular↗
PubMed1977

Deep ocular socket reconstruction.

A technique to reconstruct totally contracted sockets forms spacious, deep ocular fornices to accommodate ocular prostheses. Fixation of the midperiphery of mucous-membrane-lined, custommade conformers to the superior and inferior orbital rims secures the posterior periphery of the conformer deep in the orbit. The method restores the normal anatomy of the ocular fornices that not only extends to the orbital rims but also penetrates deeply into the orbit along its roof and floor. The procedure contrasts with conventional, frequently unsuccessful methods of socket reconstruction that form fornices only to the superior and inferior orbital rims without extending posteriorly into the orbit. Using this technique, we reconstructed deep, spacious sockets in five patients with serious socket contracture, allowing the patients to retain cosmetically acceptable artificial eyes. The principles advocated apply to all contracted sockets.

Adolescent↗
PubMed1990

Refractive state, ocular anatomy, and accommodative range of the sea otter (Enhydra lutris).

Sea otters are carnivorous, amphibious mammals that are active both above and under water. Accordingly, it might be expected that their eyes are adapted for both aerial and aqueous vision. We examined the anatomy and physiological optics of the sea otter eye with a view towards describing and explaining its amphibious visual characteristics. We employed photokeratoscopy to measure the refractive power of the sea otter cornea, which we found to be 59 D. Using video dynamic photorefraction, we found that sea otters can focus targets clearly both in air and water, relying on accommodation to compensate for the refractive loss of their corneas upon immersion in water. Our anatomical investigations revealed that the anterior epithelium of the cornea is extensively developed, as is the iris musculature, meridional ciliary muscle, and the corneoscleral venous plexus. The first feature is most likely an adaptation to the salinity of the marine environment. We believe the latter features are part of a novel, well-developed lenticular accommodative mechanism.

Accommodation, Ocular↗
PubMed1999

Does over-accomodation occur when using aircraft head-up displays?

BACKGROUND: Whether over-accommodation is caused by the use of head-up displays is still under debate. Most prior experimentation has involved cognitively demanding tasks, which are known to affect the accommodation response. The simulations have often been unrealistic and involved short working distances. HYPOTHESIS: Over-accommodation is caused not by the presence of a head-up display per se, but rather by the cognitive demand of the task. METHODS: The effect of increasing the task cognitive load and the use of forward looking infra-red imagery (FLIR) on the ocular accommodative response and task performance was assessed with a realistic head-up display assisted flying task. FLIR increases cognitive load due to its poor resolution and the need for interpretation of the images. RESULTS: Over-accommodation was found to be small in magnitude (0.17+/-0.03D; range -0.02-0.45D) occurring only with cognitively demanding tasks and with forward looking infrared imagery. Response times to detect tanks in the outside world scene were slower with increased cognitive load and forward looking infra-red imagery, along with a reduced detection rate, decreased accuracy of tracking tanks in the outside world and poorer control of the head-up display pitch ladder. When discrimination was added to detection in an outside world task, decisions were delayed until they could be accurately made, rather than performance degraded. CONCLUSION: The use of a virtual head-up display in a simulated aircraft environment did not adversely affect ocular accommodation. However, increased cognitive demand or FLIR imagery caused significant inward shifts of accommodation.

Accommodation, Ocular↗
PubMed1979

The Mandelbaum effect: evidence for an accommodative bias toward intermediate viewing distances.

Previous research has shown that ocular accommodation tends to correspond to an intermediate distance, the dark focus, in the absence of effective stimulation. The present experiments measured accommodative responses in the presence of two adequate, monocular stimuli superimposed optically at different distances. In Experiment I, observers attempted to maintain a matrix of letters in clear focus as a superimposed mesh screen was varied in distance. In experiment II, observers were instructed to focus the "easier" of two similar grating patterns that were presented over a range of distances with a constant separation of two diopters. The results of both experiments showed an accomodative response bias toward target distances near the observers' dark focus of accommodation. The implications of these findings for the theoretical resting state of accomodation and for practical problems of visual performance are discussed.

Accommodation, Ocular↗
PubMed1998

Neurons in the posterior interposed nucleus of the cerebellum related to vergence and accommodation. I. Steady-state characteristics.

The present study used single-unit recording and electrical microstimulation techniques in alert, trained rhesus monkeys to examine the involvement of the posterior interposed nucleus (IP) of the cerebellum in vergence and accommodative eye movements. Neurons related to vergence and ocular accommodation were encountered within a circumscribed region of the IP and their activity during changes in viewing distance was characterized. The activity of these neurons increased with decreases in vergence angle and accommodation (the far-response) but none showed changes in activity during changes in conjugate eye position and we therefore term them "far-response neurons." Far-response neurons were found within a restricted region of the IP that extended approximately 1 mm rostrocaudally and mediolaterally and 2 mm dorsal to the fourth ventricle. Microstimulation of this far-response region of the IP with low currents (<30 microA) often elicited divergence and accommodation for far. The behavior of 37 IP far-response neurons was examined during normal binocular viewing, during monocular viewing (blur cue alone), and during binocular viewing with accommodation open-loop (disparity cue alone). The activity of all cells was modulated under all three conditions. However, the change in activity of some of these neurons was significantly different under these three viewing conditions. The behavior of 70 IP far-response neurons was compared during normal binocular viewing and during viewing in which the accommodative response was significantly dissociated from the vergence response. The data from these two conditions was pooled and multiple regression analyses for each neuron generated two coefficients expressing the activity of the neuron relative to the vergence and to accommodative response respectively. On the basis of these coefficients, the overall activity of the neurons were classified as follows: 34 positively correlated with divergence, 11 positively correlated with far accommodation, 14 positively correlated with divergence and far accommodation, 9 positively correlated with divergence and accommodation, and 2 positively correlated with convergence and far accommodation. The results of this study demonstrate the involvement of a specific region of the posterior interposed nucleus of the cerebellum in vergence and accommodation. IP far-response neurons are active for vergence and accommodation irrespective of whether or not these eye movements are elicited by blur or disparity cues. The data in the present study strongly suggest that this cerebellar region is a far-response region that is involved in vergence as well as accommodative eye movements.

Accommodation, Ocular↗
PubMed2002

Are there age differences in the accommodative response curve between 3 and 14 years of age?

The monocular ocular accommodative responses of 118 emmetropic children, aged from 3 to 14 years, were measured at five different stimulus distances (0, 1, 2, 3, 4 D) from the principal plane of the eye with a Canon Autoref R-1. The change in the accommodative response curve in emmetropic children between 3 and 14 years old was found to be negligible.

Accommodation, Ocular↗
PubMed2002

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.

Accommodation, Ocular↗
PubMed1986

Disparity-induced and blur-induced convergence eye movement and accommodation in the monkey.

The dynamics of vergence eye movement and of ocular accommodation were studied in two monkeys trained to track a haploscopically presented target that appeared to move in depth. The target was presented under four conditions: monocular viewing, normal binocular viewing, accommodation-open-loop binocular viewing, and "conflict" viewing, in which the accommodation and vergence stimuli did not correspond to those produced by any real target in three-dimensional space. The first and third conditions were chosen because in each case only one of the two primary cues that guide accommodation and vergence was operative: blur in the first case and disparity in the third. We usually studied responses to apparent target movement directly toward or away from the right eye, in which accommodation was measured. The latencies of the accommodation responses to steps toward the monkey were approximately 180 and 240 ms in the two monkeys, while in both monkeys the latencies of convergence were approximately 160 ms. Neither the vergence latencies nor the accommodation latencies were greatly different in monocular and binocular viewing. Responses to a sinusoidally moving target (frequencies 0.1-1.2 Hz; peak-to-peak amplitude 0.5-4 diopters or meter-angles) were studied in the first three of the above viewing conditions. In binocular viewing, even with accommodation open-loop, vergence and accommodation showed much smaller phase lags than in monocular viewing. Furthermore, in response to step changes, both vergence and accommodation velocities were higher in binocular viewing than in monocular viewing. Thus the dynamic control of both vergence and accommodation relies predominantly on disparity signals. At low frequencies (0.2 or 0.3 Hz) the monkeys showed only a modest ability to separate their accommodation and vergence responses when presented with conflicting blur and disparity cues. A simple linear calculation based on the data above was used to predict the responses in such situations. The predicted and observed responses were in reasonable agreement.

Accommodation, Ocular↗
PubMed1995

Visual accommodation as a cue for size.

Accommodation micropsia is examined in the general context of ocular accommodation as a cue for object size. The nature and limits of accommodation micropsia and arguments dealing with the possible contribution of accommodation to the perception of size are reviewed. Literature on the anomalous myopias, the intermediate-resting hypothesis, and theories of ciliary muscle innervation is examined critically in so far as it bears on the accommodation-micropsia hypothesis. The anomalous myopias and evidence for the intermediate-resting hypothesis are well documented, but without a mechanism for proprioceptive feedback from the ciliary complex about the state of accommodation it can only be concluded that such feedback would have to be indirect, either via the reflex link with vergence, or possibly through the agency of efference-copy neurones.

Accommodation, Ocular↗
PubMed1993

Amplitudes of accommodation of primate lenses refilled with two types of inflatable endocapsular balloons.

OBJECTIVE: To investigate the maintenance of ocular accommodation by refilling the lenses of the eyes of youthful primates with inflatable endocapsular balloons. METHODS: The lenses of 21 cynomolgus monkeys were refilled following endocapsular phacoemulsification with a balloon that either approximates the shape of the non-accommodated lens or the accommodated crystalline lens. RESULTS: In nine of 15 successfully refilled lenses, we were able to perform automated refractometry to determine the amplitude of accommodation, ie, changes in refraction before and 1 hour after application of topical 4% pilocarpine hydrochloride to alter lens shape. At 2 weeks, 2 to 3 months, and 6 to 12 months after operation, mean (+/- SD) accommodation was 4.6 +/- 2.5, 2.5 +/- 0.5, and 1.7 +/- 0.7 diopters (D), respectively, in the lenses refilled with the nonaccommodation balloon (n = 5; preoperative value, 15.2 +/- 1.3 D), and it was 1.9 +/- 0.5, 1.3 +/- 0.9, and 1.8 +/- 0.9 D, respectively, in the lenses refilled with the accommodation balloon (n = 4; preoperative value, 17.0 +/- 2.9 D). CONCLUSION: The greater yield of accommodation with the nonaccommodation balloon is consistent with the recent theory on the mechanism of accommodation. Although the obtained accommodation was a small fraction of values determined prior to the operation and the small amplitude of accommodation decreased over time, the feasibility of refilling the lens with an inflatable endocapsular balloon, allowing at least some accommodation in the eyes of youthful primates, was demonstrated. Applied to humans, this procedure may allow accommodation following cataract surgery.

Accommodation, Ocular↗
PubMed2002

Clinical testing of accommodative facility: Part 1. A critical appraisal of the literature.

BACKGROUND: Accommodative facility testing is used in clinical care to assess functioning of the ocular accommodative system. The current clinical standard (binocular assessment using +/- 2.00 D lenses at 40 cm with a vectographic suppression check) was first described nearly 20 years ago as part of the last comprehensive review of the literature. The standard accommodative facility test imposes a variable requirement on patients of different ages who have a wide range of accommodative amplitudes. METHOD: In this article, we critically reviewthe present body of literature on accommodative facility testing, with emphasis on the relation between symptoms, accommodative amplitude, and the results found during accommodative facility testing. RESULT: We include discussion of the five broad categories of accommodative facility studies: (11 recommendations for testing criteria; (2) normative data investigations; (3) reliability and variability assessment; (4) relation between accommodative facility and symptoms; and (5) other relationships (e.g., effect of test parameters on accommodative facility). CONCLUSION: Given the substantial variation in demand when testing patients of different ages (amplitudes), it is not surprising that a significant variation in responses has been reported in the clinical accommodative facility literature. Future clinical investigation of accommodative facility would benefit from a systematic investigation into the relationship between age and amplitude. The presence or absence of symptoms needs to be considered so that results of testing can be analyzed in relation to the severity of binocular vision-related symptoms.

Accommodation, Ocular↗
PubMed1997

Accommodation without feedback suggests directional signals specify ocular focus.

Accommodation was monitored continuously under open-loop conditions while subjects viewed a sinusoidally oscillating sine-wave grating (0.2 Hz; +/- 1 D; 2.7 c/d; 0.56 contrast) in a Badal optometer. The target was illuminated by monochromatic light (590 nm) or white light (3000 K) with longitudinal chromatic aberration (LCA) normal, doubled, neutralized and reversed. Subjects (12) accommodated well in white light with LCA normal and doubled (mean gains = 0.85 and 0.94), gain was reduced in the neutralized condition (0.54), in monochromatic light (0.43), and especially when LCA was reversed (0.30). The results suggest that accommodation responds to changes in the relative contrast of spectral components of the retinal image and perhaps to the vergence of light.

Accommodation, Ocular↗
PubMed1989

Reproducible stimulation of ciliary muscle contraction in the cynomolgus monkey via a permanent indwelling midbrain electrode.

To better study the pivotal role of the ciliary muscle in ocular accommodation and aqueous humor outflow, a technique was developed to permit long-term reproducible stimulation of the muscle via the normal efferent neuronal pathway in cynomolgus monkeys. Following a small midline craniotomy, the stereotaxic coordinates of the Edinger-Westphal (E-W) nucleus were localized by contrast ventriculoradiography. A bipolar stimulating electrode was stereotaxically positioned to generate the maximum accommodative amplitude, and then permanently affixed to the surrounding cranium. Once experience was gained, the implant procedure required approximately 3 h and was well-tolerated by the animals, which subsequently exhibited normal behavior and no apparent discomfort or neurological deficits. Most animals retained the implant seemingly permanently (8-42 months follow-up), although a few animals extruded them after 4-8 months. Electrode placement in the E-W nucleus was verified histologically. The stimulation current and frequency-accommodative response relationships varied remarkably little between eyes, animals, or experimental sessions, although there was moderate inter-animal variation in the maximum accommodative amplitude. Using square-wave pulses of 0.5 ms duration, maximum accommodation, averaging approximately 15 diopters, was achieved at approximately 700 microA and approximately 70 Hz, and was greater under pentobarbital than under halothane anesthesia. Topical application of carbachol, eserine and echothiophate to the eye induced more accommodation than did central electrical stimulation. Permanent implantation of a stimulating electrode into the E-W nucleus may facilitate study of ocular physiological parameters dependent upon ciliary muscle contraction.

Accommodation, Ocular↗
PubMed2000

The relation between accommodative facility and general binocular dysfunction.

This study was designed to evaluate the relation between accommodative facility and accommodative and binocular dysfunctions. We determined whether failure to achieve 8 cycles per minute of binocular accommodative facility or 11 cycles per minute of monocular accommodative facility tends to be associated with these dysfunctions. Forty eight subjects, ages 10-30 years were examined and classified into four groups: 13 subjects with accommodative dysfunctions, 11 patients with binocular dysfunctions, 12 subjects with accommodative and binocular dysfunctions and 12 control subjects with refractive errors but no accommodative or binocular anomalies. Monocular and binocular accommodative facility was conducted using +/- 2.00 D flip lenses. In general, statistical analysis indicates that subjects with binocular and accommodative (ocular motor) anomalies performed significantly poorer than subjects of normal group on monocular and binocular facility tests. Monocular accommodative facility results showed more information about the dysfunction of the patient compared with the results of the binocular accommodative facility. In general data supported a relation between reduced accommodative facility and a general binocular dysfunction (accommodative or binocular) which demonstrates the importance of the accommodative facility test in diagnosing an accommodative or binocular anomaly.

Accommodation, Ocular↗