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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 9/2019

01-09-2019 | Refractive Errors | Miscellaneous

The influence of age, refractive error, visual demand and lighting conditions on accommodative ability in Malay children and adults

Authors: Ai-Hong Chen, Azmir Ahmad, Stephanie Kearney, Niall Strang

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 9/2019

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Abstract

Purpose

Near work, accommodative inaccuracy and ambient lighting conditions have all been implicated in the development of myopia. However, differences in accommodative responses with age and refractive error under different visual conditions remain unclear. This study explores differences in accommodative ability and refractive error with exposure to differing ambient illumination and visual demands in Malay schoolchildren and adults.

Methods

Sixty young adults (21–25 years) and 60 schoolchildren (8–12 years) were recruited. Accommodative lag and accommodative fluctuations at far (6 m) and near (25 cm) were measured using the Grand Seiko WAM-5500 open-field autorefractor. The effects of mesopic room illumination on accommodation were also investigated.

Results

Repeated-measures ANOVA indicated that accommodative lag at far and near differed significantly between schoolchildren and young adults [F(1.219, 35.354) = 11.857, p < 0.05]. Post hoc tests using the Bonferroni correction showed that at near, there was a greater lag in schoolchildren (0.486 ± 0.181 D) than young adults (0.259 ± 0.209 D, p < 0.05). Repeated-measures ANOVA also revealed that accommodative lag at near demands differed statistically between the non-myopic and myopic groups in young adults and schoolchildren [F(3.107, 31.431) = 12.187, p < 0.05]. Post hoc tests with Bonferroni correction showed that accommodative lag at near was significantly greater in myopic schoolchildren (0.655 ± 0.198 D) than in non-myopic schoolchildren (0.202 ± 0.141 D, p < 0.05) and myopic young adults (0.316 ± 0.172 D, p < 0.05), but no significant difference was found between myopic young adults (0.316 ± 0.172 D) and non-myopic young adults (0.242 ± 0.126 D, p > 0.05). Accommodative lag and fluctuations were greater under mesopic room conditions for all ages [all p < 0.05].

Conclusion

Greater accommodative lag was found in myopes than in emmetropes, in schoolchildren than in adults, and under mesopic conditions than under photopic conditions. Accommodative fluctuations were greatest in myopes and in mesopic conditions. These results suggest that differences exist in the amount of blur experienced by myopes and non-myopes at different ages and under different lighting conditions.
Literature
1.
Hashim SE, Tan HK, Wan-Hazabbah WH, Ibrahim M (2008) Prevalence of refractive error in Malay primary school children in suburban area of Kota Bharu, Kelantan, Malaysia. Ann Acad Med Singap 37(11):940–946PubMed
2.
Ramlee A, Pin GP (2012) Ocular biometric measurements in emmetropic and myopic Malaysian children - a population-based study. Med J Malaysia 67(5):497–502
3.
Garner LF, Chung KM, Grosvenor TP, Mohidin M (1990) Ocular dimension and refractive power in Malay and Malanesian children. Ophthalmic Physiol Opt 10:234–238CrossRefPubMed
4.
Goh PP, Abqariyah Y, Pokharel GP, Ellwein LB (2005) Refractive error and visual impairment in school-age children in Gombak District, Malaysia. Ophthalmology 112(4):678–685CrossRefPubMed
5.
Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P (2008) Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 115(8):1279–1285CrossRefPubMed
6.
Saw SM, Goh PP, Cheng A, Shankar A, Tan DT, Ellwein LB (2006) Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore. Br J Ophthalmol 90(10):1230–1235CrossRefPubMedPubMedCentral
7.
Rose KA, Morgan IG, Smith W, Burlutsky G, Mitchell P, Saw S (2008) Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney. Arch Ophthalmol 126(4):527–530CrossRefPubMed
8.
Lam CS, Goldschmidt E, Edwards MH (2004) Prevalence of myopia in local and international schools in Hong Kong. Optom Vis Sci 81(5):317–322CrossRefPubMed
9.
Kleinstein RN, Jones LA, Hullett S, Kwon S, Lee RJ, Friedman NE, Manny RE, Mutti DO, Julie AY, Zadnik K (2003) Refractive error and ethnicity in children. Arch Ophthalmol 121(8):1141–1147CrossRefPubMed
10.
Saw SM, Wu HM, Seet B, Wong TY, Yap E, Chia KS, Stone RA, Lee L (2001) Academic achievement, close up work parameters, and myopia in Singapore military conscripts. Br J Ophthalmol 85(7):855–860CrossRefPubMedPubMedCentral
11.
Zylbermann R, Landau D, Berson D (1993) The influence of study habits on myopia in Jewish teenagers. J Pediatr Ophthalmol Strabismus 30(5):319–322PubMed
12.
Goldschmidt E, Jacobsen N (2014) Genetic and environmental effects on myopia development and progression. Eye. 28(2):126–133CrossRefPubMed
13.
Chakraborty R, Ostrin LA, Nickla DL, Iuvone PM, Pardue MT, Stone RA (2018) Circadian rhythms, refractive development, and myopia. Ophthalmic Physiol Opt 38(3):217–245CrossRefPubMedPubMedCentral
14.
Saw SM, Chua WH, Hong CY (2002) Near-work in early-onset myopia. Invest Ophthalmol Vis Sci 43(2):332–339PubMed
15.
Ip JM, Saw S, Rose KA, Morgan IG, Kifley A, Wang JJ, Mitchell P (2008) Role of near work in myopia: findings in a sample of Australian school children. Invest Ophthalmol Vis Sci 49(7):2903–2910CrossRefPubMed
16.
Kinge B, Midelfart A, Jacobsen G, Rystad J (2000) The influence of nearwork on development of myopia among university students. A three-year longitudinal study among engineering students in Norway. Acta Ophthalmol 78(1):26–29CrossRef
17.
Lin Z, Vasudevan B, Mao GY, Ciuffreda KJ, Jhanji V, Li XX, Zhou HJ, Wang NL, Liang YB (2016) The influence of near work on myopic refractive change in urban students in Beijing: a three-year follow-up report. Graefes Arch Clin Exp Ophthalmol 254(11):2247–2255CrossRefPubMed
18.
Hung GK, Ciuffreda KJ (2007) Incremental retinal-defocus theory of myopia development—schematic analysis and computer simulation. Comput Biol Med 37(7):930–946CrossRefPubMed
19.
Flitcroft DI (1998) A model of the contribution of oculomotor and optical factors to emmetropization and myopia. Vis Res 38(19):2869–2879CrossRefPubMed
20.
Norton T (1999) Animal models of myopia: learning how vision controls the size of the eye. ILAR J 40(2):59–77CrossRefPubMed
21.
Day M, Seidel D, Gray LS, Strang NC (2009) The effect of modulating ocular depth of focus upon accommodation microfluctuations in myopic and emmetropic subjects. Vis Res 49(2):211–218CrossRefPubMed
22.
Day M, Strang N, Seidel D, Gray L, Mallen EA (2006) Refractive group differences in accommodation microfluctuations with changing accommodation stimulus. Ophthalmic Physiol Opt. 26:88–96CrossRefPubMed
23.
Abbott ML, Schmid KL, Strang NC (1998) Differences in the accommodation stimulus response curves of adult myopes and emmetropes. Ophthalmic Physiol Opt. 18(1):13–20CrossRefPubMed
24.
Berntsen DA, Sinnott LT, Mutti DO, Zadnik K (2011) Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction. Vis Res 51(9):1039–1046CrossRefPubMed
25.
Chen AH, Abidin AH (2002) Vergence and accommodation system in Malay primary school children. Malays J Med Sci 9(1):9–15PubMedPubMedCentral
26.
Mutti DO, Mitchell GL, Hayes JR, Jones LA, Moeschberger ML, Cotter SA, Kleinstein RN, Manny RE, Twelker JD, Zadnik K (2006) Accommodative lag before and after the onset of myopia. Invest Ophthalmol Vis Sci 47(3):837–846CrossRefPubMed
27.
Yeo A, Kang K, Tang W (2006) Accommodative stimulus response curve of emmetropes and myopes. Ann Acad Med Singap 35(12):868–874PubMed
28.
29.
Kaufman JE, Christensen JF (1972) IES lighting handbook: the standard lighting guide. Illuminating Engineering Society, New York
30.
Borsting E, Tosha C, Chase C, Ridder WH III (2010) Measuring near induced transient myopia in college students with visual discomfort. Optom Vis Sci 87:760CrossRefPubMedPubMedCentral
31.
Day M, Strang NC, Seidel D, Gray LS (2008) Effect of contact lenses on measurement of the accommodation microfluctuations. Ophthalmic Physiol Opt. 28(1):91–95PubMed
32.
Lin Z, Vasudevan B, Zhang YC, Qiao LY, Liang YB, Wang NL, Ciuffreda KJ (2012) Reproducibility of nearwork-induced transient myopia measurements using the WAM-5500 autorefractor in its dynamic mode. Graefes Arch Clin Exp Ophthalmol 250(10):1477–1483CrossRefPubMed
33.
McBrien NA, Millodot M (1986) The effect of refractive error on the accommodative response gradient. Ophthalmic Physiol Opt. 6:145–149PubMed
34.
Sreenivasan V, Irving EL, Bobier WR (2014) Can current models of accommodation and vergence predict accommodative behavior in myopic children? Vis Res 101:51–61CrossRefPubMed
35.
Yeo AC, Atchison DA, Schmid KL (2013) Children’s accommodation during reading of Chinese and English texts. Optom Vis Sci 90(2):156–163CrossRefPubMed
36.
Atchison DA, Varnas SR (2017) Accommodation stimulus and response determinations with autorefractors. Ophthalmic Physiol Opt. 37(1):96–104CrossRefPubMed
37.
Monticone PP, Menozzi M (2011) A review on methods used to record and analyze microfluctuations of the accommodation in the human eye. J Eur Opt Soc 6:1103CrossRef
38.
Dobson V, Quinn GE, Siatkowski RM, Baker JD, Hardy RJ, Reynolds JD, Trese MT, Tung B (1999) Agreement between grating acuity at age 1 year and Snellen acuity at age 5.5 years in the preterm child. Cryotherapy for retinopathy of prematurity cooperative group. Invest Ophthalmol Vis Sci 40(2):496–503PubMed
39.
Corchuelo V, Pulgarín JD, Dolmetsch AM (2015) Ocular motility in children between ages 7 and 15. In: VI Latin American congress on biomedical engineering CLAIB 2014, Paraná, Argentina 29, 30 & 31 October 2014. Springer, Cham, pp 95–98
40.
Chen AH, O’Leary DJ, Howell ER (2000) Near visual function in young children. Part I: near point of convergence. Part II: amplitude of accommodation. Part III: near heterophoria. Ophthalmic Physiol Opt. 20(3):185–198CrossRefPubMed
41.
Benzoni JA, Rosenfield M (2012) Clinical amplitude of accommodation in children between 5 and 10 years of age. Optom Vis Dev 43(3):109–114
42.
Mutti DO, Jones LA, Moeschberger ML, Zadnik K (2000) AC/a ratio, age, and refractive error in children. Invest Ophthalmol Vis Sci 41:2469–2478PubMed
43.
Seidel D, Gray LS, Heron G (2003) Retinotopic accommodation responses in myopia. Invest Ophthalmol Vis Sci 44(3):1035–1041CrossRefPubMed
44.
Bailey MD, Sinnott LT, Mutti DO (2008) Ciliary body thickness and refractive error in children. Invest Ophthalmol Vis Sci 49(10):4353–4360CrossRefPubMed
45.
Rabbetts RB (1998) Ocular aberrations. In: Butterworth-Heinemann (ed) Clinical visual optics, 3rd edn. Butterworth Heinemann, Oxford, pp 288–289
46.
47.
Cufflin M, Mankowska A, Mallen E (2007) Effect of blur adaptation on blur sensitivity and discrimination in emmetropes and myopes. Invest Ophthalmol Vis Sci 48(6):2932–2939CrossRefPubMed
48.
Aggarwala KR, Kruger ES, Mathews S, Kruger PB (1995) Spectral bandwidth and ocular accommodation. J Opt Soc Am 12(3):450–455CrossRef
49.
Zloto O, Wygnanski-Jaffe T, Farzavandi SK, Gomez-de-Liaño R, Sprunger DT, Mezer E (2018) Current trends among pediatric ophthalmologists to decrease myopia progression-an international perspective. Graefes Arch Clin Exp Ophthalmol 256(12):2457–2466CrossRefPubMed
50.
51.
52.
Charman WN, Radhakrishnan H (2009) Accommodation, pupil diameter and myopia. Ophthalmic Physiol Opt 29(1):72–79CrossRefPubMed
53.
Buehren T, Collins MJ (2006) Accommodation stimulus–response function and retinal image quality. Vis Res 46(10):1633–1645CrossRefPubMed
54.
55.
Maqsood F (2017) Effects of varying light conditions and refractive error on pupil size. Cogent Med 4(1):1338824CrossRef
56.
Chen Z, Niu L, Xue F, Qu X, Zhou Z, Zhou X, Chu R (2012) Impact of pupil diameter on axial growth in orthokeratology. Optom Vis Sci 89(11):1636–1640CrossRefPubMed
57.
Guillon M, Dumbleton K, Theodoratos P, Gobbe M, Wooley CB, Moody K (2016) The effects of age, refractive status, and luminance on pupil size. Optom Vis Sci 93(9):1093CrossRefPubMedPubMedCentral
58.
Kasthurirangan S, Glasser A (2006) Age related changes in the characteristics of the near pupil response. Vis Res 46(8-9):1393–1403CrossRefPubMed
59.
He JC, Sun P, Held R, Thorn F, Sun X, Gwiazda JE (2002) Wavefront aberrations in eyes of emmetropic and moderately myopic school children and young adults. Vis Res 42(8):1063–1070CrossRefPubMed
60.
Hazel CA, Cox MJ, Strang NC (2003) Wavefront aberration and its relationship to the accommodative stimulus-response function in myopic subjects. Optom Vis Sci 80(2):151–158CrossRefPubMed
61.
Lopez-Gil N, Martin J, Liu T, Bradley A, Díaz-Muñoz D, Thibos LN (2013) Retinal image quality during accommodation. Ophthalmic Physiol Opt. 33(4):497–507CrossRefPubMedPubMedCentral
62.
Gwiazda J, Thorn F, Bauer J, Held R (1993) Myopic children show insufficient accommodative response to blur. Invest Ophthalmol Vis Sci 34(3):690–694PubMed
Metadata
Title
The influence of age, refractive error, visual demand and lighting conditions on accommodative ability in Malay children and adults
Authors
Ai-Hong Chen
Azmir Ahmad
Stephanie Kearney
Niall Strang
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 9/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-019-04405-z

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