Effect of target luminance on microfluctuations of accommodation

Less is more: optimal recording time for measuring the steady-state accommodative response

Clinical Relevance Background: Steady-state accommodation is frequently evaluated with open-field autorefractors; however there is no consensus regarding the optimal test duration. Our results allow us to standardise the procedure followed for the assessment of the steady-state accommodative response in clinical and laboratory settings and may be of great relevance in time-constrained situations.

BACKGROUND

The present study aims to determine the optimal recording time to assess the magnitude and variability of the accommodative response with a binocular open-field autorefractor.

METHODS

The steady-state accommodative response of 84 healthy undergraduate students was dynamically measured using the Grand Seiko WAM-5500 autorefractor at 500 cm, 40 cm and 20 cm for 90 s while participants maintained focus on a stationary target. We examined the reliability and level of agreement between four time intervals (the first 10-s, 30-s, 60-s and 90-s) at three accommodative demands (0.2D, 2.5D and 5D).

RESULTS

The magnitude of accommodation showed an excellent level of reliability (intraclass correlation coefficient [ICC]> 0.90) for the comparisons between the 90-s, 60-s and 30-s time intervals at the three viewing distances tested. However, when including the 10-s interval, there was a moderate reduction of the reliability indices and an increase of the mean difference between two time intervals (intra-class correlation [ICC] ranging from 0.89 to 0.97; and ESs ranging from 0.16 to 0.42). For the variability of accommodation, we observed an excellent reliability for the comparisons of the 90-s and 60-s measures at the three accommodative demands (ICC: 0.95-0.96), whereas for the rest of comparisons we observed from moderate to good levels of reliability.

CONCLUSION

Our data indicate that of 30-s and 60-s are enough to accurately assess the magnitude and variability of the accommodative response with the WAM-5500 autorefractor, respectively.

Manipulating expectancies in optometry practice: Ocular accommodation and stereoacuity are sensitive to placebo and nocebo effects

INTRODUCTION

There is scientific evidence that an individual's beliefs and/or expectations play a role in the behavioural and physiological response to a given treatment. This study aimed to assess whether the dynamics of the accommodative response and stereoacuity are sensitive to experimentally induced placebo and nocebo effects.

METHODS

Nineteen healthy university students performed three experimental sessions (placebo, nocebo and control) in randomised order, with the dynamics of the accommodative response (magnitude and variability), stereoacuity and subjective measures being assessed in all sessions. For the experimental manipulation, participants ingested an inert capsule that was alleged to have positive (white capsule, placebo condition) or negative (yellow capsule, nocebo conditions) effects on the human physiology. In the control condition, participants did not ingest a capsule.

RESULTS

The data revealed that the variability of accommodation was sensitive to experimentally induced placebo and nocebo effects, showing a more stable accommodative response for the placebo compared with the nocebo condition (corrected p-value = 0.04, Cohen's d = 0.60). In addition, better stereoacuity was found with the placebo, compared with the nocebo (corrected p-value = 0.01, Cohen's d = 0.69) and control (corrected p-value = 0.03, Cohen's d = 0.59) conditions. Successful experimental manipulation was confirmed by the analysis of subjective perceptions.

CONCLUSIONS

These findings provide evidence that manipulating expectations about the efficacy of an inert treatment affect the dynamics of the accommodative response (variability of accommodation) and stereoacuity. The results have important applications in both clinical and research outcomes, where individuals´ beliefs/expectations could modulate the visual function.

Seeing the future: Predictive control in neural models of ocular accommodation

Ocular accommodation is the process of adjusting the eye's crystalline lens so as to bring the retinal image into sharp focus. The major stimulus to accommodation is therefore retinal defocus, and in essence, the job of accommodative control is to send a signal to the ciliary muscle which will minimize the magnitude of defocus. In this article, we first provide a tutorial introduction to control theory to aid vision scientists without this background. We then present a unified model of accommodative control that explains properties of the accommodative response for a wide range of accommodative stimuli. Following previous work, we conclude that most aspects of accommodation are well explained by dual integral control, with a “fast” or “phasic” integrator enabling response to rapid changes in demand, which hands over control to a “slow” or “tonic” integrator which maintains the response to steady demand. Control is complicated by the sensorimotor latencies within the system, which delay both information about defocus and the accommodation changes made in response, and by the sluggish response of the motor plant. These can be overcome by incorporating a Smith predictor, whereby the system predicts the delayed sensory consequences of its own motor actions. For the first time, we show that critically-damped dual integral control with a Smith predictor accounts for adaptation effects as well as for the gain and phase for sinusoidal oscillations in demand. In addition, we propose a novel proportional-control signal to account for the power spectrum of accommodative microfluctuations during steady fixation, which may be important in hunting for optimal focus, and for the nonlinear resonance observed for low-amplitude, high-frequency input. Complete Matlab/Simulink code implementing the model is provided at https://doi.org/10.25405/data.ncl.14945550.

Variability of Accommodative Microfluctuations in Myopic and Emmetropic Juveniles during Sustained near Work

Near work has been considered to be a potential risk factor for the onset of myopia, but with inadequate evidence. Chinese adolescents use digital devices for near work, such as study and entertainment purposes, especially during the COVID-19 pandemic. In this study, we investigated the influence of prolonged periods of near work on accommodative response, accommodative microfluctuations (AMFs), and pupil diameter between juvenile subjects of myopia and emmetropia. Sixty juveniles (30 myopes and 30 emmetropes) were recruited for the study. Participants were instructed to play a video game on a tablet PC at a distance of 33.3 cm for 40 min. Accommodative response and pupil diameter were measured with an open-field infrared refractometer in High-speed mode. Parameters of the subjects were measured once every 10 min, and analyzed by one-way repeated measure ANOVA for variation tendency. There were no significant differences between emmetropia and myopia groups with respect to age and sex (p > 0.05). The low-frequency component (LFC) of myopia gradually increased with time, reached a peak at 30 min, and then declined (p = 0.043). The high-frequency component (HFC) of myopia also reached a peak at 30 min (p = 0.036). Nevertheless, there was no significant difference in the LFC (p = 0.171) or HFC (p = 0.278) of the emmetropia group at each time point. There was no significant difference in the mean and standard deviation of the accommodative response and pupil diameter both in emmetropic and myopic juveniles. Compared with juvenile emmetropes, myopes exhibit an unstable tendency in their accommodation system for prolonged near work at a certain time point. Accommodative microfluctuations may be a sensitive, objective indicator of fatigue under sustained near work in juvenile myopes.

The effect of image resolution of display types on accommodative microfluctuations

PURPOSE

To determine whether accommodative microfluctuations (AMFs) are affected by the image resolution of the display type being observed. The effect of refractive error is also examined.

METHODS

Twenty participants, (10 myopes and 10 emmetropes) observed a target on four different displays: paper, smartphone, e-reader and visual display unit screen (VDU), whilst their accommodative responses were measured using a continuous recording infrared autorefractor. The accommodative response and AMF measures comprising low frequency components (LFC), high frequency components (HFC) and the root mean square (RMS) of the AMFs were analysed.

RESULTS

A significant increase in LFC power was observed for the paper stimulus when compared to the VDU and smartphone conditions. Myopes demonstrated a significantly higher LFC and mean accommodative response compared to emmetropes across the four displays. A significant difference in the mean AR between the displays with the lowest and highest resolution was found. A higher mean AR was found with higher resolution of the image. The HFC and RMS accommodation were not affected by display type.

CONCLUSION

The mean accommodative response and the mean LFC power appear to respond differently depending on the type of display in use. Higher resolution devices showed a reduced lag of accommodation to the accommodative demand; however, this may cause a lead of accommodation in myopes for higher resolution display types.

The random walk of accommodation fluctuations

The focusing distance of the eye fluctuates during accommodation. However, the visual role of these accommodation fluctuations is not yet fully understood. The fluctuation complexity is one of the obstacles to this long standing challenge in visual science. In this work we seek to develop a statistical approach that i) accurately describes experimental measurements and ii) directly generates randomized and realistic simulations of accommodation fluctuations for use in future experiments. To do so we use the random walk approach, which is usually appropriate to describe the dynamics of systems that combine both randomness and memory.

A 12-Week-Long Intake of Bilberry Extract (Vaccinium myrtillus L.) Improved Objective Findings of Ciliary Muscle Contraction of the Eye: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Comparison Trial

A 12-week-long randomized, double-blind, placebo-controlled, parallel-group comparison trial was conducted to determine the effects of long-term standardized bilberry extract (SBE) intake on tonic accommodation of ciliary muscle caused by visual display terminal (VDT) tasks. This study was compliant with the accordance with CONSORT 2010 statement. A total of 109 healthy adult men and women aged 20–60 years were recruited and randomized into SBE and placebo groups. The subjects in the SBE and placebo groups were administered 240 mg of SBE and placebo, respectively, once daily for 12 weeks. Tests were performed before and after VDT tasks at week 0, 4, 8, and 12; high-frequency component (HFC)-1 value was the evaluation outcome. Results showed that post-load HFC-1 values at weeks 8 and 12 were significantly improved in the SBE group than in the placebo group (p = 0.014 and 0.017, respectively). This study shows that oral consumption of 240 mg SBE extract for 12 weeks relieves the tonic accommodation of the ciliary muscle caused by VDT tasks and near-vision tasks.

Objective User Visual Experience Evaluation When Working with Virtual Pixel-Based 3D System and Real Voxel-Based 3D System

Volumetric display shows promising implications for healthcare related applications as an innovative technology that creates real three-dimensional (3D) image by illuminating points in three-dimensional space to generate volumetric images without image separation. We used eccentric photorefractometry to objectively study ocular performance in a practical environment by evaluating near work-induced refraction shift, accommodative microfluctuations, and pupil size for 38 young adults after viewing anaglyph, and volumetric 3D content for prolonged time. The results of our study demonstrate that participants who performed relative depth estimation task on volumetric 3D content were less likely to experience task-induced myopic refraction shift. For both 3D content types, we observed pupil constriction, that is possibly related to visual fatigue. For anaglyph 3D pupil constriction, onset was observed significantly sooner, compared to volumetric 3D. Overall, sustained work with 3D content, and small disparities or the fully eliminated possibility of accommodation-vergence conflict, not only minimizes near work-induced myopic shift, but also provide beneficial accommodation relaxation that was demonstrated in this study as hypermetropic shift for nearly half of participants.

Creating correct blur and its effect on accommodation

Blur occurs naturally when the eye is focused at one distance and an object is presented at another distance. Computer-graphics engineers and vision scientists often wish to create display images that reproduce such depth-dependent blur, but their methods are incorrect for that purpose. They take into account the scene geometry, pupil size, and focal distances, but do not properly take into account the optical aberrations of the human eye. We developed a method that, by incorporating the viewer's optics, yields displayed images that produce retinal images close to the ones that occur in natural viewing. We concentrated on the effects of defocus, chromatic aberration, astigmatism, and spherical aberration and evaluated their effectiveness by conducting experiments in which we attempted to drive the eye's focusing response (accommodation) through the rendering of these aberrations. We found that accommodation is not driven at all by conventional rendering methods, but that it is driven surprisingly quickly and accurately by our method with defocus and chromatic aberration incorporated. We found some effect of astigmatism but none of spherical aberration. We discuss how the rendering approach can be used in vision science experiments and in the development of ophthalmic/optometric devices and augmented- and virtual-reality displays.

Cognitive Demand and Accommodative Microfluctuations

Previous studies have shown cognition to have an influence on accommodation. Temporal variation in the accommodative response occurs during the fixation on a stationary target. This constantly shifting response has been called accommodative micro-fluctuations (AMFs). The aim of this study is to determine the effects of increasing task cognitive demand on the ocular accommodation response. AMFs for 12 myopes and 12 emmetropes were measured under three conditions of varying cognitive demand and comprising reading of numbers (Num), simple arithmetic (SA), and complex arithmetic (CA). Fast Fourier transforms were used to analyze the different frequency band components of the AMFs. Other aspects of AMFs including root mean square accommodation values and chaos analysis was applied. A repeated measures ANOVA revealed a significant main effect of cognition in the mean power of the high frequency component (HFC) (F_2,44 = 10.03, p < 0.005). Pairwise analyses revealed that these differences exist between SA and CA tasks (p < 0.005) and the Num and CA (p < 0.005) tasks with the HFC power being the highest for the CA condition. It appears that the difficulty of a task does affect active accommodation but to a lesser extent than other factors affecting accommodation.

Management of digital eye strain

Digital eye strain, an emerging public health issue, is a condition characterised by visual disturbance and/or ocular discomfort related to the use of digital devices and resulting from a range of stresses on the ocular environment. This review aims to provide an overview of the extensive literature on digital eye strain research with particular reference to the clinical management of symptoms. As many as 90 per cent of digital device users experience symptoms of digital eye strain. Many studies suggest that the following factors are associated with digital eye strain: uncorrected refractive error (including presbyopia), accommodative and vergence anomalies, altered blinking pattern (reduced rate and incomplete blinking), excessive exposure to intense light, closer working distance, and smaller font size. Since a symptom may be caused by one or more factors, a holistic approach should be adopted. The following management strategies have been suggested: (i) appropriate correction of refractive error, including astigmatism and presbyopia; (ii) management of vergence anomalies, with the aim of inducing or leaving a small amount of heterophoria (~1.5^Δ Exo); (iii) blinking exercise/training to maintain normal blinking pattern; (iv) use of lubricating eye drops (artificial tears) to help alleviate dry eye-related symptoms; (v) contact lenses with enhanced comfort, particularly at end-of-day and in challenging environments; (vi) prescription of colour filters in all vision correction options, especially blue light-absorbing filters; and (vii) management of accommodative anomalies. Prevention is the main strategy for management of digital eye strain, which involves: (i) ensuring an ergonomic work environment and practice (through patient education and the implementation of ergonomic workplace policies); and (ii) visual examination and eye care to treat visual disorders. Special consideration is needed for people at a high risk of digital eye strain, such as computer workers and contact lens wearers.

Digital eye strain: prevalence, measurement and amelioration

Digital device usage has increased substantially in recent years across all age groups, so that extensive daily use for both social and professional purposes is now normal. Digital eye strain (DES), also known as computer vision syndrome, encompasses a range of ocular and visual symptoms, and estimates suggest its prevalence may be 50% or more among computer users. Symptoms fall into two main categories: those linked to accommodative or binocular vision stress, and external symptoms linked to dry eye. Although symptoms are typically transient, they may be frequent and persistent, and have an economic impact when vocational computer users are affected. DES may be identified and measured using one of several available questionnaires, or objective evaluations of parameters such as critical flicker–fusion frequency, blink rate and completeness, accommodative function and pupil characteristics may be used to provide indices of visual fatigue. Correlations between objective and subjective measures are not always apparent. A range of management approaches exist for DES including correction of refractive error and/or presbyopia, management of dry eye, incorporating regular screen breaks and consideration of vergence and accommodative problems. Recently, several authors have explored the putative role of blue light-filtering spectacle lenses on treating DES, with mixed results. Given the high prevalence of DES and near-universal use of digital devices, it is essential that eye care practitioners are able to provide advice and management options based on quality research evidence.

Sensitivity of Chaos Measures in Detecting Stress in the Focusing Control Mechanism of the Short-Sighted Eye

When fixating on a stationary object, the power of the eye’s lens fluctuates. Studies have suggested that changes in these so-called microfluctuations in accommodation may be a factor in the onset and progression of short-sightedness. Like many physiological signals, the fluctuations in the power of the lens exhibit chaotic behaviour. A breakdown or reduction in chaos in physiological systems indicates stress to the system or pathology. The purpose of this study was to determine whether the chaos in fluctuations of the power of the lens changes with refractive error, i.e. how short-sighted a subject is, and/or accommodative demand, i.e. the effective distance of the object that is being viewed. Six emmetropes (EMMs, non-short-sighted), six early-onset myopes (EOMs, onset of short-sightedness before the age of 15), and six late-onset myopes (LOMs, onset of short-sightedness after the age of 15) took part in the study. Accommodative microfluctuations were measured at 22 Hz using an SRW-5000 autorefractor at accommodative demands of 1 D (dioptres), 2 D, and 3 D. Chaos theory analysis was used to determine the embedding lag, embedding dimension, limit of predictability, and Lyapunov exponent. Topological transitivity was also tested for. For comparison, the power spectrum and standard deviation were calculated for each time record. The EMMs had a statistically significant higher Lyapunov exponent than the LOMs (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.64\pm 0.33$$\end{document}0.64±0.33 vs. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.39\pm 0.20~\hbox {D}/\hbox {s}$$\end{document}0.39±0.20D/s) and a lower embedding dimension than the LOMs (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$3.28\pm 0.46$$\end{document}3.28±0.46 vs. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$3.67\pm 0.49$$\end{document}3.67±0.49). There was insufficient evidence (non-significant p value) of a difference between EOMs and EMMs or EOMs and LOMs. The majority of time records were topologically transitive. There was insufficient evidence of accommodative demand having an effect. Power spectrum analysis and assessment of the standard deviation of the fluctuations failed to discern differences based on refractive error. Chaos differences in accommodation microfluctuations indicate that the control system for LOMs is under stress in comparison to EMMs. Chaos theory analysis is a more sensitive marker of changes in accommodation microfluctuations than traditional analysis methods.

Effect of Illumination on Ocular Status Modifications Induced by Short-Term 3D TV Viewing

Objectives. This study aimed to compare changes in ocular status after 3D TV viewing under three modes of illumination and thereby identify optimal illumination for 3D TV viewing. Methods. The following measures of ocular status were assessed: the accommodative response, accommodative microfluctuation, accommodative facility, relative accommodation, gradient accommodative convergence/accommodation (AC/A) ratio, phoria, and fusional vergence. The observers watched 3D television for 90 minutes through 3D shutter glasses under three illumination modes: A, complete darkness; B, back illumination (50 lx); and C, front illumination (130 lx). The ocular status of the observers was assessed both before and after the viewing. Results. After 3D TV viewing, the accommodative response and accommodative microfluctuation were significantly changed under illumination Modes A and B. The near positive fusional vergence decreased significantly after the 90-minute 3D viewing session under each illumination mode, and this effect was not significantly different among the three modes. Conclusions. Short-term 3D viewing modified the ocular status of adults. The least amount of such change occurred with front illumination, suggesting that this type of illumination is an appropriate mode for 3D shutter TV viewing.

Mesopic Functional Visual Acuity in Normal Subjects

To evaluate mesopic functional visual acuity (FVA) with a newly developed system in normal subjects and to compare the results with photopic FVA, sixty-eight healthy volunteers (24.03 ± 4.42 [mean ± standard deviation] years) were enrolled in this study. A commercially available FVA measurement system (AS-28; Kowa, Aichi, Japan) was modified to measure FVA under mesopic conditions as well as photopic conditions. Measurements were performed monocularly in photopic conditions during 60 seconds. After dark adaptation for 15 minutes, the same measurements were repeated in mesopic conditions. Outcomes included starting visual acuity (VA), FVA (the average of VAs), visual maintenance ratio (VMR), maximum VA, minimum VA, and numbers of blinks during the 60-second measurement session, and were compared between mesopic and photopic conditions. Starting VA was –0.11 ± 0.08 and 0.39 ± 0.12 logarithm of the minimum angle of resolution (logMAR) in photopic and mesopic conditions, respectively. FVA was –0.06 ± 0.09 and 0.52 ± 0.14 logMAR, VMR was 0.98 ± 0.02 and 0.94 ± 0.04, maximum VA was –0.15 ± 0.06 and 0.33 ± 0.12 logMAR, the minimum VA was 0.05 ± 0.12 and 0.78 ± 0.20 logMAR, and the number of blinks was 8.23 ± 7.54 and 7.23 ± 6.20, respectively. All these parameters except the number of blinks were significantly different between the two conditions (P < 0.001). Besides, the difference between maximum and minimum VAs and standard deviation of VA were significantly larger in mesopic than in photopic conditions (P < 0.001). This study revealed that not only overall visual function decline but also instability of vision under mesopic conditions even in healthy subjects.

The flickering wheel illusion: when α rhythms make a static wheel flicker

α oscillations (8-14 Hz) greatly influence brain activity, yet we generally do not experience them consciously: the world does not appear to oscillate. Dedicated strategies must exist in the brain to prevent these oscillations from disrupting normal processing. Could suitable stimuli fool these strategies and lead to the conscious experience of our own brain oscillations? We describe and explore a novel illusion in which the center of a static wheel stimulus (with 30-40 spokes) is experienced as flickering when viewed in the visual periphery. The key feature of this illusion is that the stimulus fluctuations are experienced as a regular and consistent flicker, which our human observers estimated at ~9 Hz during a psychophysical matching task. Correspondingly, the occipital α rhythm of the EEG was the only oscillation that showed a time course compatible with the reported illusion: when α amplitude was strong, the probability of reporting illusory flicker increased. The peak oscillatory frequency for these flicker-induced modulations was significantly correlated, on a subject-by-subject basis, with the individual α frequency measured during rest, in the absence of visual stimulation. Finally, although the effect is strongest during eye movements, we showed that stimulus motion relative to the retina is not necessary to perceive the illusion: the flicker can also be perceived on the afterimage of the wheel, yet by definition this afterimage is stationary on the retina. We conclude that this new flickering illusion is a unique way to experience the α rhythms that constantly occur in the brain but normally remain unnoticed.

Temporal dynamics and statistical characteristics of the microfluctuations of accommodation: dependence on the mean accommodative effort

Microfluctuations of accommodation have been the subject of many studies. New technological developments now permit us to study the dynamics of the microfluctuations with unprecedented resolution and accuracy. We aim to characterise their temporal statistics for different levels of accommodative effort, using a custom-built aberrometer. We conducted 46 s long measurements on the dominant eye of 9 young, healthy subjects. The ocular wavefront was sampled every 250 microm across the 3.9 mm measured pupil, at a frame rate of 173 Hz. This enabled us to obtain high resolution estimates of the Power Spectral Density (PSD). Results show that the shape of the estimated PSD for a 4 D effort is distinct from the shape for the two extrema of the accommodation range. The autocorrelation function of the increments of the accommodation signal is also affected by the level of effort, regardless of the refractive error of the subject.

Dual wavefront sensing channel monocular adaptive optics system for accommodation studies

Manipulation of the eye's aberrations using adaptive optics (AO) has shown that optical imperfections can affect the dynamic accommodation response. A limitation of current system designs used for such studies is an inability to make direct measurements of the eye's aberrations during the experiment. We present an AO system which has a dual wavefront sensing channel. The corrective device is a 37-actuator piezoelectric deformable mirror. The measurements used to control the mirror, and direct measurements of the eye's aberrations, are captured on a single Shack-Hartmann sensor. Other features of the system include stroke amplification of the deformable mirror and a rotating diffuser to reduce speckle.We demonstrate the utility of the system by investigating the impact of aberration dynamics on the control of steady-state accommodation on four subjects.

Age-related changes in accommodative dynamics from preschool to adulthood

PURPOSE

To study variations in dynamic measures of accommodation and disaccommodation with age in subjects ranging from preschool to adulthood.

METHODS

Accommodative responses to a step stimulus cartoon movie alternating from distance to near were recorded with a dynamic infrared photorefractor. Subjects viewed at least three stimulus cycles of far and near for four near stimulus demands (2, 3, 4, and 5 D). Latencies, peak velocities, and the magnitude of accommodative microfluctuations were calculated from the responses and compared in 41 subjects from 3 to 38 years of age.

RESULTS

Mean accommodative and disaccommodative latencies decreased linearly with age. The magnitude of accommodative microfluctuations during sustained near accommodation had a significant quadratic relationship to age, with subjects in the first decade of life having the largest fluctuations and subjects in the third decade of life having the smallest for all stimulus demands. Accommodative peak velocities were fastest in subjects in the first two decades of life, compared with subjects in the third and fourth decades; however, disaccommodative peak velocities showed no significant age differences.

CONCLUSIONS

Age-related changes in dynamics occur in accommodative and disaccommodative latencies, accommodative peak velocities, and accommodative microfluctuations, all of which decrease with increasing age from preschool to adulthood. Disaccommodative peak velocities showed no change with age.

The effect of modulating ocular depth of focus upon accommodation microfluctuations in myopic and emmetropic subjects

The magnitude of accommodation microfluctuations increases in emmetropic subjects viewing low luminance targets or viewing a target through small artificial pupils. Larger microfluctuations reported in myopia may result from an abnormally large depth of focus (DoF). The effect of modulating the size of the DoF has not been investigated in myopic subjects and may help to explain the cause of the increased DoF. Accommodation microfluctuations were recorded under two experimental conditions. Firstly, 12 emmetropes (EMMs), and 24 myopes (MYOs) viewed a Maltese Cross target with luminance levels of 0.002, 0.2, 6 and 600cd/m(2) and in darkness, and second, 14 EMMs and 16 MYOs viewed a Maltese Cross target through pupil diameters of 0.5, 1, 2, 3, 4 and 5mm presented in Maxwellian view. The magnitude of the accommodation microfluctuations increased significantly with a target luminance of 0.002cd/m(2) (p<.03) and pinhole diameters of <2mm (p<.05). For all other luminance levels and pupil diameters the magnitude was constant. For both conditions, MYOs had significantly larger microfluctuations than EMMs (p<.01). Considerable inter-subject variability was observed in the degree to which the magnitude of the microfluctuations increased, for both the 0.002cd/m(2) luminance and 0.5mm pupils, however, this was not correlated with refractive error. The increase in the magnitude of the microfluctuations while viewing a low luminance target (0.002cd/m(2)) may be due to a shallower contrast gradient in the cortical image, with a consequent increase in DoF. The microfluctuations also increase when viewing through small pupils (<2mm), which increases the DoF without altering the contrast gradient. The larger microfluctuations found in the MYOs consolidates the theory that MYOs have a larger DoF than EMMs and therefore have a higher threshold for retinal image blur.

Microsaccades drive illusory motion in the Enigma illusion

Visual images consisting of repetitive patterns can elicit striking illusory motion percepts. For almost 200 years, artists, psychologists, and neuroscientists have debated whether this type of illusion originates in the eye or in the brain. For more than a decade, the controversy has centered on the powerful illusory motion perceived in the painting Enigma, created by op-artist Isia Leviant. However, no previous study has directly correlated the Enigma illusion to any specific physiological mechanism, and so the debate rages on. Here, we show that microsaccades, a type of miniature eye movement produced during visual fixation, can drive illusory motion in Enigma. We asked subjects to indicate when illusory motion sped up or slowed down during the observation of Enigma while we simultaneously recorded their eye movements with high precision. Before "faster" motion periods, the rate of microsaccades increased. Before "slower/no" motion periods, the rate of microsaccades decreased. These results reveal a direct link between microsaccade production and the perception of illusory motion in Enigma and rule out the hypothesis that the origin of the illusion is purely cortical.

Technical note: effect of contact lenses on measurement of the accommodation microfluctuations

AIM

Dynamic measurement of accommodation in subjects with myopia usually involves recording through soft contact lenses (CLs) to correct the refractive error. Conversely, dynamic accommodation measurement in emmetropic control subjects is generally undertaken without any corrective lenses. The aim of this experiment was to determine whether CL correction affects the measurement of accommodation microfluctuations using infrared refractometry, and whether this needs to be considered in studies which attempt to compare accommodation responses between the two groups.

METHODS

Ten young emmetropic subjects viewed a high contrast Maltese cross target monocularly using the right eye at a target vergence of 0 D. The subjects viewed the target under two conditions: with CL condition and without CL condition, where the subjects viewed the target with the eye only. Accommodation responses of the right eye were recorded continuously for 2 min at a sampling rate of 52 Hz using the Shin-Nippon SRW-5000 autorefractor.

RESULTS

No significant difference (two-tailed paired t-test, t(9) = -1.499, p = 0.168) was found in mean accommodation response between the with CL (mean +/- S.D. = -0.02 +/- 0.24 D) and without CL conditions (mean +/- S.D. = +0.01 +/- 0.25 D). No significant (two-tailed paired t-test, t(9) = 0.151, p = 0.883) difference in the magnitude of the accommodation microfluctuations was found between the with CL (mean +/- S.D. = 0.162 +/- 0.04 D) and without CL condition (mean +/- S.D. = 0.169 +/- 0.04 D). Power spectrum analysis revealed no differences in the characteristics of the microfluctuations waveform between the two conditions. A control experiment carried out on a subgroup of five subjects using a negative (-3 D) CL demonstrated that there was no significant effect of the dioptric power of the CL on the magnitude of the accommodation microfluctuations (anova: F(3,15) = 0.254, p = 0.782).

CONCLUSION

Thin soft CLs do not affect the magnitude or frequency characteristics of accommodation microfluctuations when measured using the Shin-Nippon SRW-5000.

The stability of steady state accommodation in human infants

Retinal image quality in infants is largely determined by the accuracy and the stability of their accommodative responses. Although the accuracy of infants' accommodation has been investigated previously, little is known about the stability of their responses. We performed two experiments that characterized the stability of infants' steady state accommodation. Analyses were performed in the time domain (root mean square [RMS] deviation) and in the frequency domain (spectral analysis). In Experiment 1, accommodation responses were recorded for a period of 3 s from the left eye of four groups of infants (8-10, 11-13, 14-19, and 20-30 weeks of age) and eight prepresbyopic adults while they focused on a small toy placed at a dioptric viewing distance of 1.0 D (at 1 m). In Experiment 2, accommodation responses were recorded for a period of 14 s from the left eye of a group of 8- to 12-week-old infants and six prepresbyopic adults while they focused on a cartoon image placed at three different dioptric viewing distances (1.25, 2.0, and 3.0 D). The data, collected using a photorefractor sampling at 25 Hz, showed two important characteristics. First, the RMS deviations and the power were quantitatively similar across different infant age groups, and they were significantly larger in infants than in adults. Second, the overall and relative power also increased with the dioptric viewing distance both in infants and adults. At all three dioptric viewing distances, the measures of power were larger in infants than in adults. These data demonstrate that infants' accommodative responses contain instabilities that are qualitatively very similar to those observed in adults. However, the larger RMS deviations suggest that infants are likely to experience larger fluctuations in retinal image quality than adults.

The contribution of accommodation and the ocular surface to the microfluctuations of wavefront aberrations of the eye

We have used videokeratoscopy and wavefront sensing to investigate the contribution of the ocular surface and the effect of stimulus vergence on the microfluctuations of the wavefront aberrations of the eye. The fluctuations of the wavefront aberrations were quantified by their variations around the mean and by using power spectrum analysis. Integrated power was determined in two regions: 0.1-0.7 Hz (low frequencies) and 0.8-1.8 Hz (high frequencies). Changes in the ocular surface topography were measured using high-speed videokeratoscopy and variations in the ocular wavefront aberrations were measured with a wavefront sensor. The microfluctuations of wavefront aberrations of the ocular surface were found to be considerably smaller than the microfluctuations of the wavefront aberrations of the total eye. The fluctuations in defocus while viewing a closer target at 2 or 4 D were found to be significantly greater than fluctuations in defocus when viewing a far target. This increase in defocus fluctuations (p < or = 0.001) occurred in both the low- and high-frequency regions of the power spectra.

The Charles F. Prentice Award Lecture 2005: Optics of the Human Eye: Progress and Problems

The history of measurements of ocular aberration is briefly reviewed and recent work using much-improved aberrometers and large samples of eyes is summarized. When on-axis, higher-order, monochromatic aberrations are averaged, undercorrected, positive, fourth-order spherical aberration dominates; other Zernike wavefront aberration coefficients have average values near zero. Individually, however, many eyes show substantial amounts of third-order and other fourth-order aberrations; the value of these varies idiosyncratically about zero. Most normal eyes show only small amounts of axial monochromatic aberration for photopic pupils up to around 3 mm; the limits to retinal image quality are then usually set by diffraction, uncorrected or imperfectly corrected spherocylindrical refractive error, accommodation error, and chromatic aberration. Longitudinal chromatic aberration varies very little across the population. With larger mesopic and scotopic pupils, monochromatic aberration plays a more important optical role, but overall visual performance is increasingly dominated by neural factors. Some remaining problems in measuring and modeling the eye's optical performance are discussed.

Refractive group differences in accommodation microfluctuations with changing accommodation stimulus

PURPOSE

Microfluctuations of accommodation are known to increase in magnitude with increasing accommodation stimulus. Reduced sensitivity to blur in myopic subjects could also lead to increases in the magnitude of the microfluctuations. The aim of this study is to examine the effect of variations in accommodation stimulus upon the microfluctuations in different refractive groups.

METHODS

Thirty-six subjects were divided into three groups depending upon their refractive error and age of onset of their myopia; 12 emmetropes (EMMs), 12 early onset myopes (EOMs) and 12 late-onset myopes (LOMs). Steady-state accommodation responses were recorded continuously for 2 min using the Shin-Nippon SRW-5000 autorefractor at a sampling rate of 52 Hz while viewing targets at accommodation stimuli levels of 0, 1, 2, 3 and 4 D in a Badal (+5 D) optical system.

RESULTS

The EMMs and EOMs showed systematic increases in the root mean square (r.m.s.) value of the microfluctuations with increasing accommodation stimulus. In contrast, no systematic variation with accommodation stimulus was found for the LOMs. Power spectrum analysis demonstrated that increases in the size of the microfluctuations were mediated by increases in the power of the low frequency components of the accommodation response.

CONCLUSIONS

The magnitude of the microfluctuations in the EMMs and EOMs may be influenced primarily by accommodation response-induced zonular relaxation effects or to changes in the physical properties of the accommodation plant with increasing accommodation response. The LOMs may have an increased baseline neural blur threshold, which appears to modulate the magnitude of the accommodative microfluctuations for low accommodation levels. At higher accommodation demands, the changes in the physical properties of the accommodation plant or the zonular relaxation effects appear to exceed the blur threshold, and the known association between microfluctuations and accommodation stimulus level is restored.

Adaptive optics system for investigation of the effect of the aberration dynamics of the human eye on steady-state accommodation control

It is now known that defocus is not the only aberration in the eye that exhibits dynamic behavior during fixation. It is currently unknown what effects, if any, the dynamics of these other aberrations have on steady-state accommodation control. We constructed an adaptive optics system to serve as a tool for future investigations in this area. The system has several design features of interest, including automated precompensation of defocus and astigmatism and a method to bypass a scanner used to reduce speckle. It also has the facility to measure the eye's aberrations independent of the aberration manipulation device-a 37-actuator membrane deformable mirror. Coherence function analysis was used to assess the deformable mirror performance in terms of coupling between Zernike modes. Modes beyond third radial order showed severe coupling. Pilot data were collected on one subject to demonstrate the utility of this system in steady-state accommodation studies. The value of the system for future work in this area is discussed.

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.

Double lateral shearing interferometer for the quantitative measurement of tear film topography

A lateral shearing interferometer designed and built for the study of the precorneal tear film topography dynamics and its effect on visual performance is presented. Simple data processing algorithms are discussed and tested on data illustrating different tear topography features: postblink tear undulation, tear breakup, eyelid-produced bumps and ridges, bubbles, and rough precontact lens tear surfaces.

Study of the tear topography dynamics using a lateral shearing interferometer

The dynamics of the pre-corneal tear film topography are studied on 21 subjects with a purpose-built lateral shearing interferometer. Interesting tear topography features such as post-blink undulation, break-up, eyelid-produced bumps/ridges, bubbles and rough pre-contact lens tear surfaces were recorded. Using the calculated tear topography maps, the effects of the tear dynamics in visual performance, refractive surgery and ophthalmic adaptive optics are discussed in terms of wavefront RMS. The potential of lateral shearing interferometry for clinical applications such as dry eye diagnosis and contact lens performance studies is illustrated by the recorded topography features such as post-blink undulation, break-up, eyelid-produced bumps/ridges, bubbles and rough tear surfaces in front of contact lenses.

Microfluctuations of wavefront aberrations of the eye

To investigate fluctuations in the wavefront aberrations of the eye and their relation to pulse and respiration frequencies we used a wavefront sensor to measure the dynamics of the Zernike aberrations up to the polynomial fourth radial order. Simultaneously, the subject's pulse rate was measured, from which the instantaneous heart rate was derived. We used an auto-regressive process to derive the power spectra of the Zernike aberration signals, as well as pulse and instantaneous heart rate signals. Linear regression analysis was performed between the frequency components of Zernike aberrations and the pulse and instantaneous heart rate frequencies. Cross-spectrum density and coherence analyses were also applied to investigate the relation between fluctuations of wavefront aberrations, and pulse and instantaneous heart rate. The correlations between fluctuations of individual Zernike aberrations were also determined. A frequency component of all Zernike aberrations up to the fourth radial order was found to be significantly correlated with the pulse frequency (all R(2) >/= 0.51, p < 0.02), and a frequency component of nine out of 12 Zernike aberrations was also significantly correlated with instantaneous heart rate frequency (all R(2) >/= 0.46, p < 0.05). The major correlations among Zernike aberrations occurred between second-order and fourth-order aberrations with the same angular frequencies. Higher order aberrations appear to be related to the cardiopulmonary system in a similar way to that reported for the accommodation signal and pupil fluctuations.

The prospects for super-acuity: limits to visual performance after correction of monochromatic ocular aberration

It has recently been suggested that correction of the monochromatic aberration of the eye could lead to substantial improvements in visual acuity and contrast sensitivity function. After consideration of the best-corrected visual acuity of normal eyes, the optical and neural limits to visual performance are reviewed. It is concluded that, even if current problems with the accuracy of the suggested techniques of aberration correction, through corneal excimer laser ablation or customised contact lenses, can be overcome, changes in monochromatic ocular aberration over time, the continuing presence of chromatic aberration, errors of focus associated with lags and leads in accommodation, and other factors, are likely to result in only minor improvements in the high-contrast acuity performance of most normal eyes being produced by attempted aberration control. Significant gains in contrast sensitivity might, however, be achievable, particularly under mesopic and scotopic conditions when the pupil is large, provided that correct focus can be maintained. In the immediate future, reduction of the high levels of aberration that are currently found in eyes that have undergone refractive surgery and in some abnormal eyes should bring useful benefits.

Accommodative microfluctuation in asthenopia caused by accommodative spasm

BACKGROUND

Although many patients complain of eye fatigue caused by accommodative spasm, there have been no reports of a good objective examination method to diagnose it.

PURPOSE

The spectral power of the high frequency component of the accommodative microfluctuation (spectral power of HFC) differs according to the constrictive degree of the accommodation. In this paper, we expatiated upon our previously reported analyzing processes of the spectral power of HFC, and we investigated the relationship between normal subjects and subjects with asthenopia.

METHOD

The accommodative microfluctuation were recorded when the subjects were looking at a stable target. The waves of the accommodative microfluctuation were analyzed by FFT.

RESULTS

The spectral power of HFC for the distant target was 50-60 in the subjects with normal vision, but it was higher in the subjects with asthenopia.

CONCLUSION

Our results suggested that the ciliary muscle was also actively working in asthenopia caused by accommodative spasm even if the patient was looking at a distant target.

The influence of tinted lenses upon ocular accommodation

We determined the effect upon accommodative responses of tinted lenses prescribed for the relief of visual discomfort in a group of five long term lens wearers. Static and dynamic responses were measured under four viewing conditions (1) prescribed tinted lens (2) neutral density filter (3) tinted lens of complementary colour and (4) no absorptive lens. While similarity and normality of the mean stimulus-response functions between the four viewing conditions were evident, the low frequency component of the accommodation microfluctuations was significantly greater while viewing the target in the 'no lens' viewing condition. These increases in the low frequency components (LFC) of the accommodation may be a subtle indicator of visual stress in these patients. Colour specificity is not supported by this finding.

Assessment of the ocular response to topical beta-adrenoceptor antagonists using accommodative microfluctuations

Power spectrum analysis of accommodative microfluctuations has identified two dominant frequency components: a low frequency component (LFC < 0.6 Hz) and a high frequency component (1.3 Hz < HFC < 2.5 Hz). Computer-driven models of accommodation and experimental manipulation of accommodative feedback loops indicate that LFCs are likely to have a functional role in monitoring retinal image contrast during sustained accommodation. In contrast HFCs have been shown to be correlated with arterial pulse frequency and consequently their characteristics can be modified by the extra- and intra-ocular vascular (and possibly CNS) effects. For example, topical instillation of the non-selective beta-antagonist timolol maleate has shown previously the ability to modify the HFC. In an attempt to clarify proposed differences between beta-adrenoceptor antagonist agents with regard to their effects on systemic and ocular vasculature, we extend the potential offered by HFCs as a non-invasive method of assessing the ocular response to beta-antagonists to the cardioselective beta-antagonist betaxolol HCl. Accommodative microfluctuations were measured using a continuously recording infrared optometer on 10 emmetropic subjects (mean age 23.9 +/- 2.3 years) who viewed a high contrast target located at a vergence of -4 D. A double-blind protocol was employed between saline and betaxolol (0.5%, 2 x 30 microliters) following corneal anaesthesia. Local and systemic effects were separated by examining the treated and untreated eyes of three subjects. Power spectrum analysis indicated that the root mean square (r.m.s.) value and power of LFCs and HFCs were equivalent for the saline and betaxolol trials.(ABSTRACT TRUNCATED AT 250 WORDS)