Abstract
Background: In adults, higher order aberrations (HOAs) vary during accommodation [1] which reduces retinal image quality [2]. These changes may provide a mechanism linking near work and myopia development [3], however little is known about HOAs during accommodation in children. Methodology: HOAs of 90 children (mean age and spherical equivalent refraction: 8.2 ± 1.8 years; +0.63 ± 0.34 D) were measured at four accommodation demands (0, 3, 6 and 9 D) using a Hartmann-Shack aberrometer (COAS-HD). Individual Zernike term coefficients up to and including the 6th-order were analysed over a 4 mm pupil at each accommodation demand. Root mean square (RMS) errors were calculated for total (2nd-6th orders), higher order (3rd-6th orders) (HO), individual radial orders, coma (Z[3,-1], Z[3,1], Z[5,-1] and Z[5,1]), trefoil (Z[3,-3], Z[3,3], Z[5,-3] and Z[5,3]) and spherical aberration (Z[4,0] and Z[6,0]) (SA). Visual Strehl ratios based on the optical transfer function were determined from HOAs (VSOTF). Results: Total, HO, all individual orders, coma, trefoil, and SA RMS varied significantly with accommodation demand (p Conclusions: HOAs changed significantly during accommodation resulting in a significant reduction in retinal image quality at the 9 D accommodation demand. Longitudinal studies are required to examine the potential influence of these changes on eye growth.
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