September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Patterns of accommodation in lens-simulated anisometropia
Author Affiliations & Notes
  • Apoorva Karsolia
    Marshall B Ketchum University, Fullerton, California, United States
  • Lawrence R Stark
    Marshall B Ketchum University, Fullerton, California, United States
  • Footnotes
    Commercial Relationships   Apoorva Karsolia, None; Lawrence Stark, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Apoorva Karsolia, Lawrence R Stark; Patterns of accommodation in lens-simulated anisometropia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):No Pagination Specified.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Accommodation in anisometropia may respond consensually and produce a yoked accommodative response, or respond independently leading to asymmetrical accommodation responses (anisoaccommodation). A prospective, randomized study was conducted to examine the effect of conflicting accommodative stimuli in isometropic individuals (inter-ocular difference ≤ 0.5 D) with ±2 D lens-induced anisometropia and to assess the effects of viewing (binocular or monocular), anisometropia level, test distance and time on the patterns of the accommodative response.

Methods : Dynamic accommodation responses were measured in 16 young, visually-normal isometropic subjects with the Grand Seiko WAM 500 Autorefractor. In the 2 sessions, the viewing condition (monocular or binocular; direct or consensual), the testing distance (400 cm, 38.6 cm and 20.5 cm) and anisometropia level (+2 D,-2 D or no anisometropia) were randomized for each subject. In each dynamic trial, accommodation at the 5th ±0.5 second and 20th ±0.5 second was analysed to understand the patterns of the accommodative response. A within-subjects analysis of variance (ANOVA) assessed the factors in the model.

Results : A significant effect of target distance and anisometropia level was found in the group (p < 0.0001). Time as a factor was not statistically significant. Post hoc Tukey analyses showed that 3 hypothesized models of accommodation (least accommodative effort, accommodation towards tonic accommodation, and accommodation driven by ocular dominance) were significantly different from the actual binocular responses (p < 0.0001), and that 3 other models (maximum accommodative effort, weighted average of two eyes, and full anisoaccommodation) were not significantly different from the actual responses. ANOVA demonstrated a more pronounced difference between the hypothesized patterns of accommodation at the near viewing distance.

Conclusions : In the group, three hypothesized models of accommodation were better at predicting the accommodation response in lens-simulated anisometropia. These were the strategies of maximum accommodative effort, weighted average of two eyes, and anisoaccommodation. It is possible that 3 sub-groups of subjects follow each of the 3 strategies separately. Alternatively, individual subjects might switch between the 3 strategies during extended viewing.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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