Static and Dynamic Accommodation Measured Using the WAM-5500 Autorefractor

Purpose. This study was undertaken to compare static and dynamic accommodation measurements using the Grand Seiko WR-5500 (WAM) in young, phakic subjects. Methods. Fifteen subjects, aged 20 to 28 years (23.8 ± 0.58 years; mean ± SD years) participated. Accommodation was stimulated with printed text presented at various distances. In static mode, three measurements were taken for each stimulus amplitude. In dynamic mode, 5-Hz recordings were started, and subjects alternately looked through a transparent near chart and focused on a letter chart at 6 m for 5 seconds and then focused on the near letter chart for 5 seconds for a total of 30 seconds. After smoothing the raw data, the highest three individual values recorded in each 5-s interval of focusing at near were averaged for each stimulus amplitude. Analysis of variance and Bland-Altman analysis were used to compare the static and dynamic measurements. A calibration was performed with +3.00 to −10.00 D trial lenses behind an infrared filter, in 1.00 D steps in 5 of the 15 subjects. Results. Stimulus-response graphs from static and dynamic modes were not significantly different in the lower stimulus range (<5.00 D, p = 0.93), but differed significantly for the higher stimulus amplitudes (p = 0.0027). One of the 15 subjects showed a significant difference between the static and dynamic modes. Corresponding pupil diameter could be recorded along with the accommodation responses for the subjects, and pupil diameter decreased with increasing stimulus demand. Calibration curves for static and dynamic measurements were not significantly different from the 1:1 line or from each other (p = 0.32). Conclusions. Slight differences between the dynamically and statically recorded response amplitudes were identified. This is attributed to differences in the accommodative responses in this population and not to the instrument performance. Dynamic measurement of accommodation and pupil constriction potentially provides additional useful information on the accommodative response other than simply the response amplitude.

[1]  A. Glasser,et al.  Objective accommodation measurements in prepresbyopic eyes using an autorefractor and an aberrometer , 2008, Journal of cataract and refractive surgery.

[2]  R. Manny,et al.  Minus-lens-stimulated accommodative amplitude decreases sigmoidally with age: a study of objectively measured accommodative amplitudes from age 3. , 2008, Investigative ophthalmology & visual science.

[3]  Clifton M. Schor,et al.  Pulse-step models of control strategies for dynamic ocular accommodation and disaccommodation , 2006, Vision Research.

[4]  Clifton M. Schor,et al.  Dynamic control of ocular disaccommodation: First and second-order dynamics , 2006, Vision Research.

[5]  R. Held,et al.  Myopic children show insufficient accommodative response to blur. , 1993, Investigative ophthalmology & visual science.

[6]  Adrian Glasser,et al.  Amplitude dependent accommodative dynamics in humans , 2003, Vision Research.

[7]  Adrian Glasser,et al.  Age related changes in the characteristics of the near pupil response , 2006, Vision Research.

[8]  Jane Gwiazda,et al.  Comparison of Spherical Equivalent Refraction and Astigmatism Measured with Three Different Models of Autorefractors , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[9]  Adrian Glasser,et al.  Characteristics of pupil responses during far‐to‐near and near‐to‐far accommodation , 2005, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[10]  J. Wolffsohn,et al.  Clinical Evaluation of the Shin-Nippon NVision-K 5001/Grand Seiko WR-5100K Autorefractor , 2003, Optometry and vision science : official publication of the American Academy of Optometry.

[11]  Kenneth J. Ciuffreda,et al.  Dynamic aspects of accommodation: age and presbyopia , 2004, Vision Research.

[12]  H Burkhard Dick,et al.  Accommodative intraocular lenses: current status , 2005, Current opinion in ophthalmology.

[13]  W. N. Charman,et al.  Accommodation as a function of age and the linearity of the response dynamics , 2004, Vision Research.

[14]  J S Wolffsohn,et al.  Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in adults. , 2001, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[15]  Sunil Shah,et al.  Objective accommodative amplitude and dynamics with the 1CU accommodative intraocular lens. , 2006, Investigative ophthalmology & visual science.

[16]  D A Owens,et al.  The Mandelbaum effect: evidence for an accommodative bias toward intermediate viewing distances. , 1979, Journal of the Optical Society of America.

[17]  J S Wolffsohn,et al.  Subjective and objective performance of the Lenstec KH-3500 “accommodative” intraocular lens , 2006, British Journal of Ophthalmology.

[18]  A. Glasser,et al.  Objective accommodation measurements in pseudophakic subjects using an autorefractor and an aberrometer , 2009, Journal of cataract and refractive surgery.

[19]  Adrian Glasser,et al.  Minus Lens Stimulated Accommodative Lag as a Function of Age , 2009, Optometry and vision science : official publication of the American Academy of Optometry.

[20]  C. Schor,et al.  Negative feedback control model of proximal convergence and accommodation , 1992, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[21]  Frank Schaeffel,et al.  An evaluation of the lag of accommodation using photorefraction , 2003, Vision Research.

[22]  Ronald A. Schachar,et al.  Age related changes in accommodative dynamics in humans , 2007, Vision Research.

[23]  S. Mathews,et al.  Scleral expansion surgery does not restore accommodation in human presbyopia. , 1999, Ophthalmology.

[24]  Clifton M. Schor,et al.  Acceleration characteristics of human ocular accommodation , 2005, Vision Research.

[25]  Adrian Glasser,et al.  Restoration of accommodation: surgical options for correction of presbyopia , 2008, Clinical & experimental optometry.

[26]  J S Wolffsohn,et al.  Continuous recording of accommodation and pupil size using the Shin-Nippon SRW-5000 autorefractor. , 2001, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[27]  J. Mandelbaum,et al.  An accommodation phenomenon. , 1960, Archives of ophthalmology.

[28]  Adrian Glasser,et al.  Dynamics of accommodative fatigue in rhesus monkeys and humans , 2002, Vision Research.

[29]  J S Wolffsohn,et al.  Simultaneous continuous recording of accommodation and pupil size using the modified Shin‐Nippon SRW‐5000 autorefractor , 2004, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[30]  Adrian Glasser,et al.  Evaluation of a satisfied bilateral scleral expansion band patient , 2004, Journal of cataract and refractive surgery.

[31]  C. Schor,et al.  The fluctuations of accommodation and ageing. , 1995, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[32]  O. Findl,et al.  Accommodating intraocular lenses: a critical review of present and future concepts , 2007, Graefe's Archive for Clinical and Experimental Ophthalmology.

[33]  S Hasebe,et al.  Fatigue reduces tonic accommodation , 2001, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[34]  Adrian Glasser,et al.  Objective Accommodation Measurement with the Grand Seiko and Hartinger Coincidence Refractometer , 2007, Optometry and vision science : official publication of the American Academy of Optometry.