Changes In Accommodation Research Articles

Alterations in Lens Free Water Distribution Are Associated with Shape Deformation in Accommodation

To investigate whether a redistribution of water within the crystalline lens is associated with the shape deformation that occurs during accommodation. Observational, cross sectional study. Eleven young adults without presbyopia (aged 18-39 years) and 9 middle-aged adults with presbyopia (aged 40-55 years). Magnetic resonance imaging (MRI) scans of the lens were acquired on a 3 Tesla clinical MRI scanner, without and with the presentation of a 3 Diopter accommodative stimulus. The MRIs were postprocessed using established methods to extract the geometric dimensions and spatial maps of water distribution of the lens. Accommodative changes in the full 3-dimensional description of lens shape, the lens total-water distribution profile, and the lens free-water distribution profile. Viewing of an accommodative stimulus by young subjects elicited an elastic shape deformation of the lens consistent with accommodation that was associated with an elevated, smoother free-water distribution, primarily in the anterior region of the lens. In contrast, viewing of an accommodative stimulus by presbyopic subjects produced an atypical shape deformation of the lens that was instead associated with a lowered free-water distribution, primarily in the anterior region of the lens. No discernible changes to the lens total-water distribution were observed in response to the accommodative stimulus in either subject cohort. The present study suggests that protein-mediated alterations in the free-water distribution of the anterior region of the lens influence the shape deformation in accommodation, presenting pharmacological modulation of free-water distribution as an attractive novel approach for treating presbyopia. The authors have no proprietary or commercial interest in any materials discussed in this article.

Influence of power and the time of application of fogging lenses on accommodation.

Fogging is a non-invasive technique based on the use of positive spherical power lenses to relax accommodation during refraction that is commonly used as an alternative to cycloplegic drugs. Although the mechanism of the fogging technique has been described, some aspects of its methodology remain unclear. The main purpose of this work was to determine which lens power and time of application are more suitable for achieving a successful relaxation of accommodation by analyzing the changes in accommodation when fogging lenses of different powers were placed in front of the participants' eye for a certain timespan. The results of this analysis showed, in general, that low-power lenses and timespans of less than half a minute provided the highest relaxation of accommodation. However, high inter-subject variability was found in the two variables (power and time).

A pilot non-randomized trial of smartphone-based anaglyph system for treatment of adult amblyopia through VR (Virtual Reality).

To evaluate the effectiveness of amblyopia treatment through a smartphone-based anaglyph system by virtual reality (VR) in adult patients. A total of 10 subjects diagnosed with anisometropic amblyopia were enrolled during the study period. Best Corrected Visual Acuity (BCVA), stereoacuity, and contrast acuity were evaluated during three visits (at presentation, 3 months and 6 months) of smartphone-based anaglyph video run in the VR mode. All the amblyogenic factors including stereopsis, color vision, and contrast acuity were compared using Friedman two-way analysis of variance. Statistical significance was considered if P < 0.05. Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.73 ± 0.64 before Virtual reality vision therapy (VRVT) to a post-training VRVT value of 0.48 ± 0.44 (P < 0.01). Mean stereoacuity changed from a value of 560.00 ± 301.58 before VRVT to a value of 263.00 ± 143.58 seconds of arc after training (VRVT) (P < 0.01). Mean accommodation changes from a value of 15.00 ± 7.40 before training or VRVT to value of 12.60 ± 6.10 cm after training (P < 0.01). Mean contrast acuity changes from a value of 1.21 ± 0.72 at presentation to a value of 1.52 ± 0.49 log unit after VRVT. A smartphone-based anaglyph system using VR vision therapy appears to be an effective treatment option for amblyopia in adults.

Gzhelian cyclothem development in the western North China cratonic basin and its glacioeustatic, tectonic, climatic and autogenic implications

The Gzhelian Ximing Sandstone–to–No. 8 Coal succession of the Taiyuan Formation in the Linxing gas field and adjacent areas records the complex nested architecture of the Palougou Cyclothem and component cyclothems 2–10 developed in the western North China underfilled cratonic basin. Integrated facies and sequence stratigraphic analysis of core, well log, outcrop, and seismic data reveals architectural variation of the Palougou Cyclothem in the study area from southwestward retrograding incised-valley estuary and lagoon (TST) through upward and northeastward prograding coastal plain to epeiric shelf (HST) into downward and eastward prograding open-coast tidal flat and epeiric shelf with aggrading distributive fluvial system (FSST). The component cyclothems vary in the internal architecture through the Palougou Cyclothem from mixed retrogradational–progradational (R–P; R/P > 1) cyclothems 2–4 in the early TST to retrogradation-dominated (R/P ≫1) cyclothems 5–7 in the late TST, progradation-dominated (R/P ≪1) Cyclothem 8 in the HST, and fluvial aggradation-dominated cyclothems 9 and 10 in the FSST. The Palougou Cyclothem and component cyclothems constrained by conodont-bearing limestone marker beds and radiometric dating have been observed to be substantially synchronized with the Gzhelian interglacial–glacial cyclothem and nested 400-kyr cyclothems in the North American Midcontinent and Donets Basin. The cyclic change in accommodation at the scale of the Palougou Cyclothem and component cyclothems has been ascribed to the third-order interglacial–glacial cycle and fourth-order, long eccentricity (ca. 400 kyr)-driven glacioeustatic fluctuations coupled with the tectonically driven source–to–sink reorganization. The progressively decreasing siliciclastic flux and increasing vegetation through both the Palougou Cyclothem and individual component cyclothems have been ascribed to the third- and fourth-order equatorial seasonally dry–wet climatic cycles coupled with the tectonically driven source–to–sink reorganization, in concert with the Gzhelian third- and fourth-order interglacial–glacial eustatic cycles. Both the transgressive fluvial degradation and the falling-stage fluvial aggradation have been ascribed to a higher-gradient fluvial profile relative to the gradient of the receiving North China epeiric shelf. The autogenic shoreline retreat, advance and channel migration modified the depositional response to the third- and fourth-order sea level rise through time. The termination of the falling-stage fluvial channel belts in the lateral and distal floodplain mires has been ascribed to the sustained fluvial aggradation and autodetachment of the fluvial fan from the syn-depositional shoreline in response to steady fall of relative sea level. This study contributes to a proper understanding of the Gzhelian North China intracratonic cyclothem development in response to the coupled glacioeustatic, tectonic, climatic, and autogenic processes at the third- and fourth-order scales, but also provides a context within which to interpret the symbiotic relationship, and predict the distribution, of superimposed coal–sandstone–shale gas reservoirs, and to investigate the impact of depositional heterogeneities on hydrocarbon generation and migration pathways.

Pharmacological Accommodative Changes of the Anterior Segment and Its Impact on the Vault in Implantable Collamer Lens Implantation.

To estimate the accommodative changes of the anterior segment and its impact on the central and peripheral vaults after Visian Implantable Collamer Lens (ICL) (STAAR Surgical) implantation. Eighty eyes of 40 consecutive patients (mean age: 28.05 years; range: 19 to 42 years) were examined 3 months after ICL implantation. Eyes were randomly divided into a mydriasis group and a miosis group. Anterior chamber depth (ACD) to crystalline lens (ACD-L), anterior chamber depth to ICL (ACD-ICL), central distance from endothelium to sulcus to sulcus (ASL), central distance from sulcus to sulcus to crystalline lens (STS-L), central distance from ICL to sulcus to sulcus (STS-ICL), and central (cICL-L), midperipheral (mICL-L), and peripheral (pICL-L) vaults were measured by ultrasound biomicroscopy at baseline and after induction with tropicamide or pilocarpine. After tropicamide treatment, cICL-L, mICL-L, and pICL-L decreased from 0.531 ± 0.200, 0.419 ± 0.173, and 0.362 ± 0.150 mm to 0.488 ± 0.171, 0.373 ± 0.153, and 0.311 ± 0.131 mm, respectively. The values decreased from 0.540 ± 0.185, 0.445 ± 0.172, and 0.388 ± 0.149 mm to 0.464 ± 0.199, 0.378 ± 0.156, and 0.324 ± 0.137 mm after pilocarpine administration, respectively. The ASL and STS showed a significant increase in the mydriasis group (all P ≤ .038), but a decrease in the miosis group (all P < .001). The ACD-L increased and STS-L decreased in the mydriasis group (all P < .001), indicating the backward shift of the crystalline lens, whereas crystalline lens forward shift was observed in the miosis group. Additionally, the STS-ICL decreased in both groups (all P ≤ .021), suggesting the ICL backward shift. Both central and peripheral vaults decreased during the pharmacological accommodation process, and the ciliaris-iris-lens complex contributed to the changes. [J Refract Surg. 2023;39(6):414-420.].

Depositional cycles in a rift lacustrine basin linked with tectonics, climate, and source rocks and reservoirs development: Lower Cretaceous in Naiman sag, Songliao Basin, Inner Monglia, Northeast China

In order to improve understanding of the depositional evolution processes in rift lacustrine basins in Northeast China under Early Cretaceous greenhouse climate fluctuations, the roles of tectonics and climate along with the development of source rocks and reservoirs in the evolution of continental rift lacustrine basins in Naiman sag, Songliao Basin, Inner Monglia, were studied. Based on the detailed facies analysis of the subsurface boreholes, eight facies were identified in the Lower Cretaceous strata of Naiman sag and were grouped into three facies associations, namely fan delta, littoral to sublittoral lacustrine, and deep lacustrine. Based on the depositional characteristics, in combination with lacustrine evaporites and carbonate deposition, organic matter preservation, and lake depth, the Lower Cretaceous strata of the Naiman sag was further subdivided into four lake stages, namely initial formation of lake (Stage 1), sediment-fill shallow lake (Stage 2), rising to a high lake (Stage 3), and lake closure (Stage 4), respectively. The lake evolution in the Naiman sag was driven by both tectonics and climate changes. Fault-driven subsidence was likely contributed to episodic changes in accommodation and lake formation (Stage 1), expansion (Stage 3) and shrinkage (Stage 4). A combination of regional and global climate overprint controlled the sedimentary characteristics, depositional trends, and sediment and water supply. The global climate of ocean anoxic events 1a and 1b (OAE1a and OAE1b) may have effects on anoxic conditions of Stages 1 and 3, respectively. During regional climate changes between arid, hot and humid, seasonal climate tended to form evaporite deposits and multiple layers of oil shale deposits in Stage 1. During the more humid regional climate, steady runoff tended to form fan delta deposits prograding into the lake basin in Stages 2 and 4 and thick-bedded oil shale deposits in Stage 3. The development of source rocks is linked with lake formation and expansion stages (Stages 1 and 3), and the source rocks are mainly preserved in the deep lacustrine and littoral to sublittoral lacustrine environment. The development of reservoirs is associated with lake formation, sediment-fill, and shrinkage stages (Stages 1, 2, and 4), and the reservoirs are mainly preserved in the fan delta environment.

Obesogenic Environment in the medical field: First year findings from a five-year cohort study.

Background: Doctors with a normal BMI and healthy living habits have shown to be more confident and effective in providing realistic guidance and obesity management to their patients. This study investigated obesogenic tendencies of medical students as they progress in their medical studies. Methods: A cohort of forty-nine medical students enrolled in a five-year cohort study and was followed up after one year. At the initiation of the cohort, socio-demography and information on anthropometry, accommodation, eating behavior, stress and sleeping habits of the students had been recorded. Follow-up data was collected using a standardized self-administered questionnaire. Results: Thirty-seven percent of the students in the cohort are either obese or overweight in the one-year period.. A year of follow-up suggests that there is an increase in BMI among the male students (P=0.008) and the changes are associated with changes in accommodation (P=0.016), stress levels (P=0.021), and sleeping habits (P=0.011). Conclusion: Medical education system should seriously consider evaluating this aspect in the curriculum development to help our future medical practitioners practice a healthy lifestyle and be the initiator of change in the worsening prevalence of obesity worldwide.

Sedimentary characteristics of sandy braided river deposits and factors controlling their deposition: A case study of the lower Shihezi Formation in the northern ordos basin, China

Fluvial sandstones have been identified as significant reservoirs due to their importance in global hydrocarbon exploration. The current study investigated the sedimentary characteristics and temporal evolution of sandy braided river systems as well as the factors controlling their deposition in the Lower Shihezi Formation (H1-1 to H1-4 sub-member) of the Xinzhao area in the northern Ordos Basin using well logs, core intervals, whole rock geochemical data, and other measured reservoir parameters. Within the braided river deposits, five architectural elements were identified: multistory braided channel, single-story braided channel, sandy braid bar, overbank, and floodplain. The evolution of architectural elements in the Lower Shihezi Formation is closely related to paleoclimatic conditions and tectonic activity. Climate influences sediment accumulation through its effect on terrestrial detrital input, and tectonism influences stacking patterns and architectural style by influencing subsidence rates and accommodation changes. High sediment deliveries and high-energy hydrodynamic conditions in warm and humid climates, combined with low subsidence rates and low accommodation/sediment supply (A/S) ratios, can result in the formation of highly amalgamated braided channels and braid bars as well as complex vertical stacking patterns and aggradational processes in the H1-2 and H1-3 sub-members. Conversely, the dry and hot climates, high subsidence rates and associated high A/S ratios are responsible for the low detrital influx input, stacking of isolated sand bodies, and high preservation of overbank and floodplain deposits in the H1-4 sub-member. Considering the accommodation-based systems tracts, we contend that climate and tectonism both have a significant impact on the evolution and architectural styles of sandy braided river deposits. It is suggested that climates control the stacking pattern of fluvial sand bodies during high accommodation systems tracts, whereas both climates and accommodation spaces influence architectural styles and the degree of sand body amalgamation during low accommodation systems tracts. Considering the thick, highly amalgamated sand bodies with better reservoir properties and high vertical and lateral connectivity in the H1-2 and H1-3 sub-members, we posit that these stacked multistory sand bodies should be the preferential targets for hydrocarbon exploration. The findings of this study can further elucidate the architectural styles and factors that influence the deposition of sandy braided river systems under complex tectonic and climatic conditions.

Vergence and accommodation responses in the control of intermittent exotropia.

Individuals with different types of intermittent exotropia (IXT) may use neurally coupled accommodation and vergence responses differently from those without exotropia to achieve eye alignment. This study examined the relationship between simultaneously recorded accommodation and vergence responses in children and young adults with a range of types of IXT while aligned and deviated. Responses of 29 participants with IXT (4-31 years) and 24 age-matched controls were recorded using simultaneous eye-tracking and eccentric photorefraction while they watched a movie in binocular or monocular viewing at varying viewing distances. Gradient response AC/A ratios and fusional vergence ranges were also assessed. Eight participants had divergence or pseudo-divergence excess type IXT, 5 had convergence insufficiency and 16 had basic IXT. Control and IXT participants accommodated similarly both in monocular and binocular-aligned conditions to visual targets at 80 and 33 cm. When deviated in binocular viewing, most participants with IXT exhibited changes in accommodation <0.5D relative to alignment. Gradient response AC/A ratios were similar for control [0.56 MA/D (IQR: 0.51 MA/D)] and IXT participants [0.42 MA/D (0.54 MA/D); p = 0.60]. IXT participants showed larger vergence to accommodation ratios with changes from distance to near fixation [1.19 MA/D (1.45 MA/D)] than control participants [0.78 MA/D (0.60 MA/D); p= 0.02], especially among IXT participants with divergence or pseudo-divergence excess. Participants with IXT exhibited typical fusional divergence ranges beyond their dissociated position [8.86 Δ (7.10 Δ)] and typical fusional convergence ranges from alignment [18 Δ (15.75 Δ)]. This study suggests that control of IXT is typically neither driven by accommodative convergence alone nor associated with over-accommodation secondary to fusional convergence efforts. These simultaneous measurements confirmed that proximal vergence contributed significantly to IXT control, particularly for divergence or pseudo-divergence excess type IXT. For IXT participants in this study, achieving eye alignment did not conflict with having clear vision.

Changes in accommodation in children with hyperopic anisometropia and unilateral amblyopia after laser refractive surgery and pleoptic treatment

This study comparatively analyzes the state of accommodation in children with hyperopic anisometropia and amblyopia after femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) combined with pleoptic treatment, and after conventional pleoptic treatment. The first group consisted of 30 children with medium and high hyperopia, high and medium amblyopia, and anisometropia greater than 3.0 diopters, who underwent Femto-LASIK in the amblyopic eye. The second group consisted of 28 children with similar local status, who were prescribed traditional correction and received conservative treatment. The follow-up period was 1.5 years. After 1.5 years, higher visual acuity (p<0.05) was achieved in the first group. A significant increase in the coefficient of accommodative response (CAR) was observed in the operated amblyopic eyes in group 1 - by 0.1±0.02 c.u. compared to the control group (p<0.05). In both groups there was an upwards trend for the coefficient of microfluctuations (CMF) in the amblyopic eye, but in the first group CMF increased more significantly (p<0.05). The objective accommodative response (OAR) and positive relative accommodation (PRA) of the amblyopic eye showed a double increase - by 1.0±0.23 and 0.9±0.38 diopters, respectively, at the end of treatment in the first group. The increase in similar indicators in the second group was insignificant (p<0.05). In children of the first group the difference in ciliary muscle thickness (CMT) of the amblyopic eye with disabled and enabled accommodation increased by 0.04±0.01 mm (p<0.05) in the anterior part of the ciliary muscle at the levels of CMTmax and CMT1. The data obtained in this study indicate the strong effect of refractive laser surgery in combination with pleoptic treatment on improving the visual acuity and the state of accommodation of the amblyopic and paired dominant eyes in children with hyperopic anisometropia, in contrast to conventional methods of treatment.

Changes in Accommodation and Vergence Measurements After Smartphone Use in Healthy Young Adults

Background The primary objective of this study was to explore the impacts of extended smartphone usage on accommodation and vergence measurements among healthy young adults. Specifically it seeks to identify any changes that may occur in these ocular functions as a result of extended use of smartphones.Objectives To determine pre and post accommodation and vergence components.Methods A cross-sectional research project was conducted at Mangala College of Allied Health Sciences in Mangalore. The study involved 32 young and healthy individuals with normal vision emmetropia aged between 18 to 25 years. After initial visual screening the participants were evaluated for their accommodation and vergence abilities. Specifically they were asked to read N8 text on a smartphone device placed at a working distance of 40 cm for a duration of 30 minutes. Measurements were taken before and after this task and tabulated for analysis.Results In this study a total of 32 participants were included comprising of 12 37 males and 20 63 females with an average age of 19.00plusmn1.21 years. The results obtained from the assessment of accommodation and vergence measurements before and after 30 minutes of reading on a smartphone device indicate statistically significant changes.Conclusion The findings of this research indicate that prolonged reading on a smartphone device for 30 minutes can have a significant impact on the accommodation vergence and unit of vision for the individual.

Accommodative Facility and Vergence Facility after Mobile Gaming

Aim: This study aimed to access the changes of accommodation and vergence before and after mobile gaming. Settings and Design: This was a comparative study conducted in the outpatient department of ophthalmology. Accommodative facility and vergence facility were measured using flippers. Methods and Materials: A comparative study was conducted on 50 healthy subjects, in both males and females, with age groups ranging between 18 and 30 years. This study has been approved by the IRB Committee; 25 young emmetropic patients and 25 young myopic patients were included. The comparison of accommodative facility and vergence facility before and after mobile gaming for 1 h was measured to determine the level of changes in accommodation and vergence. All patients were undergone comprehensive ophthalmic examination including vision, subjective/objective refraction, anterior segment examination, and accommodative and vergence facilities measured using accommodative and vergence flippers. Results: The mean and standard deviation value significantly increase before and after mobile gaming in the right eye, left eye, and both eyes in case of accommodation facility, and there is a decrease in the mean and standard deviation value in case of vergence facility in both eyes before and after mobile gaming. Conclusion: The mean and standard deviation value significantly increase before and after mobile gaming in the right eye, left eye, and both eyes in case of accommodative facility, and there is a decrease in the mean and standard deviation value in case of vergence facility in both eyes before and after mobile gaming.

The Influence of Accommodation on Retinal Peripheral Refraction Changes in Different Measurement Areas.

The change in refraction caused by accommodation inevitably affects the peripheral defocus state and thus may influence the effect of retinal peripheral myopic defocus measures in myopia control. This study investigated accommodation changes in different peripheral retinas under cycloplegia to help improve myopia control. Fifty-six eyes of fifty-six myopic subjects were recruited for this prospective study. The center and peripheral retina refractions were measured using multispectral refractive topography. The subjects were divided into low-to-moderate myopia group (range: -1.25 D to -6.00 D) and high myopia group (range: -6.25 D to -9.75 D) according to spherical equivalent (SE). The compound tropicamide (0.5% tropicamide and 0.5% phenylephrine) was used to relax the accommodation. The difference between cycloplegia and non-cycloplegia peripheral retinal refraction was analyzed using the t-test. The correlation between eccentricity and changes in peripheral refraction was analyzed using Pearson's correlation analysis. The manifest refraction of the retina significantly decreased with an increase in eccentricity after cycloplegia. The annular refraction difference value at 50°-53° (ARDV 50-53) showed the largest refraction decrease of 1.31 D compared with the central retinal refraction decrease of 0.84 D. The inferior quadrantal refraction difference value had the least change compared to the other quadrants. The relative peripheral refraction (RPR) changes in refraction difference value (RDV) at 15° (RDV-15), RDV-30, and RDV-45 were less than 0.15 D. When the range of annulus narrowed to 5°, the narrower annulus showed faster change with eccentricity increase in ARDV 30-35, ARDV 35-40, ARDV 40-45, ARDV 45-50, and ARDV 50-53. The RPR was highly correlated with eccentricity (R = 0.938 and P < 0.001). The high myopia group had a greater hyperopic shift in the periphery than the low-to-moderate group after cycloplegia. Peripheral refraction showed a significant hyperopic shift after cycloplegia with an increase in eccentricity. The RPR became more hyperopic than the central refraction. The high myopia group showed more hyperopic shifts in the peripheral region. Accommodation should be taken into consideration in peripheral defocus treatment.

Особенности аккомодационной функции у детей при различных видах рефракционных нарушений

Nowadays, no single concept has been found that could interpret all morphological and functional changes in the eye during accommodation. This review of Russian and foreign publications is devoted to the analysis of accommodation function in various children's refractive disorders. The analysis shows that each refractive change is characterized by certain features in the accommodation process. The most significant changes in accommodation were found in anisotropic children, it's characterized by anisoacomodation, low accommodation response, and weak unstable accommodation. To exclude persistent functional disorders, it is necessary to diagnosis refractive disorders on early stages and manage their treatment. Key words: accommodation, anisoaccomodation, hyperopia, myopia, anisometropia

Improvement in Accommodation and Dynamic Range of Focus After Laser Scleral Microporation: A Potential Treatment for Presbyopia.

To examine the ocular changes in accommodation, wavefront aberrations, and dynamic range of focus (DROF) after laser scleral microporation (LSM) for treating presbyopia. Four presbyopic aged cynomolgus macaques (>13 years; n = 8 eyes) were included. All eyes received LSM with erbium: yttrium-aluminum-garnet laser. Spherical equivalent, true accommodation, pseudo-accommodation, wavefront aberrations, and extended range of focus (EROF), or collectively known as DROF, were evaluated using a ray tracing aberrometer. True accommodation referred to the difference in spherical equivalent between distance and near vision, whereas EROF (sum of true and pseudo-accommodation) was determined by measuring the difference in diopters (D) between near and distance through-focus curves, at 50% threshold of the visual Strehl ratio of optical transfer function. From before to seven months after surgery, there was a significant increase in true accommodation from 0.6 ± 1.0 D before surgery to 5.9 ± 2.8 D at seven months after surgery (P < 0.001). EROF increased significantly from 3.4 ± 1.0 D before surgery to 11.1 ± 4.6 D at seven months after surgery (P < 0.001). Ocular aberrations did not vary significantly between preoperative and various postoperative timepoints in either disaccommodated or accommodated states (P > 0.05). No adverse event such as scleral perforation or hypotony was noted. This non-human primate study demonstrated that LSM serves as a novel therapy for improving accommodation and DROF function biomechanically, with a positive response observed throughout the seven-month postoperative period. This proof-of-concept study highlights the potential of LSM as a novel treatment for vision recovery in presbyopic eyes.

Accommodation Response Variations in University Students under High Demand for Near-Vision Activity.

The objective of this study was to investigate accommodation changes and visual discomfort in a university student population after a period of high demand for near-vision activity. A total of 50 university students aged between 20 and 22 years were recruited. The tests performed involved positive relative accommodation (PRA), negative relative accommodation (NRA), accommodation amplitude (AA), and monocular and binocular accommodative facility (MAF and BAF). Visual discomfort was measured on a scale involving a visual discomfort questionnaire (VDQ). All accommodative variables underwent changes during the exam period; specifically, regarding NRA and PRA, 30.4% and 15.1% of the studied population, respectively, appeared to be below average. Moreover, 42.3% of the population exhibited values below average in the second measure of AA. On the other hand, a small percentage of the population was below average in MAF and BAF measurements: 3% in the monocular right eye test, 6% in the left eye test, and 9.1% in the binocular facility test. Finally, the VDQ score did not reveal a statistically significant difference between the two measurements. Prolonged near-distance work, such as a university exams period, changed all accommodation systems (amplitude of accommodation, relative accommodation, and accommodation facility). These changes influence an accommodation excess that results in blurred vision, headache, and problems with focusing.

Changes in accommodation with visual fatigue among digital device users

Background: Visual fatigue is categorized as a complex phenomenon that decreases visual performance. The aim of the present study was to assess changes in accommodation at different levels of visual fatigue among students of a Malaysian private university using digital devices.&#x0D; Methods: In this cross-sectional study, students regardless of sex and ethnicity were included. A comprehensive eye examination was performed. After estimating the level of visual fatigue, the amplitude of accommodation (AA), accommodation facility (AF), and monocular estimation method (MEM) were measured. The visual fatigue questionnaire was filled out by the participants. Participants were categorized based on the visual fatigue scores into low, moderate, and high visual fatigue groups. Moderate and severe visual fatigue groups were combined, as the distribution of participants was uneven across the groups. Accommodation parameters were measured for each group and compared between the two groups, i.e., the low visual fatigue group and the combined moderate to severe visual fatigue group.&#x0D; Results: We enrolled a total of 86 students, including 29 (33.72%) men and 57 (66.28%) women, with a mean (standard deviation [SD]) age of 22.02 (1.51) years and age ranging from 19 to 26 years. By ethnicity, there were 69 (80.23%) Chinese, five (5.81%) Indian, four (4.65%) Malay, and eight (9.30%) participants from other ethnicities. Most participants were in the low visual fatigue group (54.65%), followed by the severe (25.58%) and moderate (19.77%) visual fatigue groups. AA for both eyes and AF for the right eye differed significantly between the two groups (both P &lt; 0.05). None of the accommodative parameters correlated with visual fatigue (P &gt; 0.05).&#x0D; Conclusions: Binocular AA and monocular AF significantly differed between the visual fatigue groups, but MEM was comparable. However, none of the accommodative parameters correlated with visual fatigue. These perceived vision dysfunctions could affect the visual skills of students. Therefore, future studies on the relationship between the observed dysfunctions and students’ reading performance are necessary.

Effect of Spectacle Lenses with Highly Aspherical Lenslets on Binocular Vision and Accommodation in Myopic Children with and without Intermittent Exotropia.

Purpose To evaluate the influence of spectacle lenses with highly aspherical lenslets (HAL) on binocular vision and accommodation in myopic children with intermittent exotropia (IXT) and compare the changes after wearing HAL in binocular vision and accommodation in myopic children with or without IXT. Method Forty myopic subjects aged 8–12 years were recruited: 20 with IXT and 20 visually normal children. Stereoacuity, phoria, accommodative facility, fusional vergence, vergence facility, near point of convergence, amplitude of accommodation, and accommodative response (AR) were measured by wearing HAL or single vision spectacle lenses (SVL) in a random order after adapting for 20 minutes. Accommodative microfluctuation (AMF) was defined as the standard deviation of AR. Changes in binocular vision and accommodation after wearing HAL were compared between the two groups. Results No significant differences were found in binocular vision after wearing HAL versus SVL in either group (all P > 0.05). A greater AMF was found after wearing HAL than after wearing SVL in both groups (0.04 D, 95% confidence interval (CI), 0.03 to 0.05 D, P < 0.001 for the IXT group; 0.05 D, 95% CI, 0.03 to 0.07 D, P < 0.001 for the visually normal group); however, the other accommodation parameters did not change significantly (all P > 0.05). There were no differences in the changes after wearing HAL in any parameter between the two groups (all P > 0.05). Conclusion HAL did not significantly change the binocular vision and accommodation for myopic children with or without IXT except for AMF in the short term.

Changes in accommodation and convergence function after refractive surgery in myopic patients.

In recent years, with the gradual maturation of myopia correction surgery, the changes in binocular visual function after surgery have attracted widespread attention. The accommodation of facility, the amplitude of accommodation, relative accommodation, and accommodation convergence/accommodation assembly are essential parameters for assessing binocular visual function. The changes in these parameters are significant for guiding patients in the design of the preoperative surgical approach and alleviating postoperative visual fatigue. This paper aims to guide the preoperative assessment, design, and postoperative visual training of refractive surgery in myopic patients from the perspective of changes in binocular visual function before and after myopia and surgery, which can improve accommodation and convergence function in patients after refractive surgery.

Neuroplasticity of peripheral axonal properties after ischemic stroke.

ObjectiveThis study investigated how peripheral axonal excitability changes in ischemic stroke patients with hemiparesis or hemiplegia, reflecting the plasticity of motor axons due to corticospinal tract alterations along the poststroke stage.MethodsEach subject received a clinical evaluation, nerve conduction study, and nerve excitability test. Nerve excitability tests were performed on motor median nerves in paretic and non-paretic limbs in the acute stage of stroke. Control nerve excitability test data were obtained from age-matched control subjects. Some patients underwent excitability examinations several times in subacute or chronic stages.ResultsA total of thirty patients with acute ischemic stroke were enrolled. Eight patients were excluded due to severe entrapment neuropathy in the median nerve. The threshold current for 50% compound muscle action potential (CMAP) was higher in paretic limbs than in control subjects. Furthermore, in the cohort with severe patients (muscle power ≤ 3/5 in affected hands), increased threshold current for 50% CMAP and reduced subexcitability were noted in affected limbs than in unaffected limbs. In addition, in the subsequent study of those severe patients, threshold electrotonus increased in the hyperpolarization direction: TEh (100–109 ms), and the minimum I/V slope decreased. The above findings suggest the less excitable and less accommodation in lower motor axons in the paretic limb caused by ischemic stroke.ConclusionUpper motor neuron injury after stroke can alter nerve excitability in lower motor neurons, and the changes are more obvious in severely paretic limbs. The accommodative changes of axons progress from the subacute to the chronic stage after stroke. Further investigation is necessary to explore the downstream effects of an upper motor neuron insult in the peripheral nerve system.