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Biomedical subjects

Bernard Gilmartin

Publications and source records attributed to Bernard Gilmartin.

At least 19 recordsLinked to original sources
PubMed2006

Pupil response to color signals in cone-contrast space.

PURPOSE: It is widely accepted that pupil responses to visual stimuli are determined by the ambient illuminance, and recently it has been shown that changes in stimulus color also contributes to a pupillary control mechanism. However, the role of pupillary responses to chromatic stimuli is not clear. The aim of this study was to investigate how color and luminance signals contribute to the pupillary control mechanism. METHODS: We measured pupillary iso-response contours in M-and L-cone contrast space. The iso-response contours in cone-contrast space have been determined to examine what mechanisms contribute to the pupillary pathway. The shapes of the iso-response contour change when different mechanisms determine the response. RESULTS: It was shown that for all subjects, the pupillary iso-response contours form an ellipse with positive slope in cone-contrast space, indicating that the sensitivities to the chromatic stimuli are higher than those for the luminance stimuli. The pupil responds maximally to a grating that has a stronger L-cone modulation than the red-green isoluminant grating. CONCLUSIONS: The sensitivity of the chromatic pathway, in terms of pupillary response, is three times larger than that of the luminance pathway, a property that might have utility in clinical applications.

Color Perception↗
PubMed2006

Changes in ocular physiology, tear film characteristics, and symptomatology with 18 months silicone hydrogel contact lens wear.

PURPOSE: The purpose of this study was to evaluate the longitudinal changes in ocular physiology, tear film characteristics, and symptomatology experienced by neophyte silicone hydrogel (SiH) contact lens wearers in a daily-wear compared with a continuous-wear modality and with the different commercially available lenses over an 18-month period. METHODS: Forty-five neophyte subjects were enrolled in the study and randomly assigned to wear one of two SiH materials: lotrafilcon A or balafilcon A lenses on either a daily- (LDW; BDW) or continuous-wear (LCW; BCW) basis. Additionally, a group of noncontact lens-wearing subjects (control group) was also recruited and followed over the same study period. Objective and subjective grading of ocular physiology were carried out together with tear meniscus height (TMH) and noninvasive tear breakup time (NITBUT). Subjects also subjectively rated symptoms and judgments with lens wear. After initial screening, subsequent measurements were taken after 1, 3, 6, 12, and 18 months. RESULTS: Subjective and objective grading of ocular physiology revealed a small increase in bulbar, limbal, and palpebral hyperemia as well as corneal staining over time with both lens materials and regimes of wear (p < 0.05). No significant changes in NITBUT or TMH were found (p > 0.05). Subjective symptoms and judgment were not material- or modality-specific. CONCLUSIONS: Daily and continuous wear of SiH contact lenses induced small but statistically significant changes in ocular physiology and symptomatology. Clinical measures of tear film characteristics were unaffected by lens wear. Both materials and regimes of wear showed similar clinical performance. Long-term SiH contact lens wear is shown to be a successful option for patients.

Adolescent↗
PubMed2006

Dynamic measurement of accommodation and pupil size using the portable Grand Seiko FR-5000 autorefractor.

PURPOSE: The purpose of this study was to evaluate the potential of the portable Grand Seiko FR-5000 autorefractor to allow objective, continuous, open-field measurement of accommodation and pupil size for the investigation of the visual response to real-world environments and changes in the optical components of the eye. METHODS: The FR-5000 projects a pair of infrared horizontal and vertical lines on either side of fixation, analyzing the separation of the bars in the reflected image. The measurement bars were turned on permanently and the video output of the FR-5000 fed into a PC for real-time analysis. The calibration between infrared bar separation and the refractive error was assessed over a range of 10.0 D with a model eye. Tolerance to longitudinal instrument head shift was investigated over a +/-15 mm range and to eye alignment away from the visual axis over eccentricities up to 25.0 degrees . The minimum pupil size for measurement was determined with a model eye. RESULTS: The separation of the measurement bars changed linearly (r2 = 0.99), allowing continuous online analysis of the refractive state at 60 Hz temporal and approximately 0.01 D system resolution with pupils >2 mm. The pupil edge could be analyzed on the diagonal axes at the same rate with a system resolution of approximately 0.05 mm. The measurement of accommodation and pupil size were affected by eccentricity of viewing and instrument focusing inaccuracies. CONCLUSIONS: The small size of the instrument together with its resolution and temporal properties and ability to measure through a 2 mm pupil make it useful for the measurement of dynamic accommodation and pupil responses in confined environments, although good eye alignment is important.

Accommodation, Ocular↗
PubMed2006

Three-dimensional modeling of the human eye based on magnetic resonance imaging.

PURPOSE: A methodology for noninvasively characterizing the three-dimensional (3-D) shape of the complete human eye is not currently available for research into ocular diseases that have a structural substrate, such as myopia. A novel application of a magnetic resonance imaging (MRI) acquisition and analysis technique is presented that, for the first time, allows the 3-D shape of the eye to be investigated fully. METHODS: The technique involves the acquisition of a T2-weighted MRI, which is optimized to reveal the fluid-filled chambers of the eye. Automatic segmentation and meshing algorithms generate a 3-D surface model, which can be shaded with morphologic parameters such as distance from the posterior corneal pole and deviation from sphericity. Full details of the method are illustrated with data from 14 eyes of seven individuals. The spatial accuracy of the calculated models is demonstrated by comparing the MRI-derived axial lengths with values measured in the same eyes using interferometry. RESULTS: The color-coded eye models showed substantial variation in the absolute size of the 14 eyes. Variations in the sphericity of the eyes were also evident, with some appearing approximately spherical whereas others were clearly oblate and one was slightly prolate. Nasal-temporal asymmetries were noted in some subjects. CONCLUSIONS: The MRI acquisition and analysis technique allows a novel way of examining 3-D ocular shape. The ability to stratify and analyze eye shape, ocular volume, and sphericity will further extend the understanding of which specific biometric parameters predispose emmetropic children subsequently to develop myopia.

Adult↗
PubMed2006

Objective accommodative amplitude and dynamics with the 1CU accommodative intraocular lens.

PURPOSE: To compare the objective accommodative amplitude and dynamics of eyes implanted with the one-compartment-unit (1CU; HumanOptics AG, Erlangen, Germany) accommodative intraocular lenses (IOLs) with that measured subjectively. METHODS: Twenty eyes with a 1CU accommodative IOL implanted were refracted and distance and near acuity measured with a logMAR (logarithm of the minimum angle of resolution) chart. The objective accommodative stimulus-response curve for static targets between 0.17 and 4.00 D accommodative demand was measured with the SRW-5000 (Shin-Nippon Commerce Inc., Tokyo, Japan) and PowerRefractor (PlusOptiX, Nürnberg, Germany) autorefractors. Continuous objective recording of dynamic accommodation was measured with the SRW-5000, with the subject viewing a target moving from 0 to 2.50 D at 0.3 Hz through a Badal lens system. Wavefront aberrometry measures (Zywave; Bausch & Lomb, Rochester, NY) were made through undilated pupils. Subjective amplitude of accommodation was measured with the RAF (Royal Air Force accommodation and vergence measurement) rule. RESULTS: Four months after implantation best-corrected acuity was -0.01 +/- 0.16 logMAR at distance and 0.60 +/- 0.09 logMAR at near. Objectively, the static amplitude of accommodation was 0.72 +/- 0.38 D. The average dynamic amplitude of accommodation was 0.71 +/- 0.47 D, with a lag behind the target of 0.50 +/- 0.48 seconds. Aberrometry showed a decrease in power of the lens-eye combination from the center to the periphery in all subjects (on average, -0.38 +/- 0.28 D/mm). Subjective amplitude of accommodation was 2.24 +/- 0.42 D. Two years after 1CU implantation, refractive error and distance visual acuity remained relatively stable, but near visual acuity, and the subjective and objective amplitudes of accommodation decreased. CONCLUSIONS: The objective accommodating effects of the 1CU lens appear to be limited, although patients are able to track a moving target. Subjective and objective accommodation was reduced at the 2-year follow-up. The greater subjective amplitude of accommodation is likely to result from the eye's depth of focus of and the aspheric nature of the IOL.

Accommodation, Ocular↗
PubMed2006

Wavefront analyzers induce instrument myopia.

PURPOSE: To assess the accuracy of three wavefront analyzers versus a validated binocular open-view autorefractor in determining refractive error in non-cycloplegic eyes. METHODS: Eighty eyes were examined using the SRW-5000 open-view infrared autorefractor and, in randomized sequence, three wavefront analyzers: 1) OPD-Scan (NIDEK, Gamagori, Japan), 2) WASCA (Zeiss/Meditec, Jena, Germany), and 3) Allegretto (WaveLight Laser Technologies AG, Erlangen, Germany). Subjects were healthy adults (19 men and 21 women; mean age: 20.8 +/- 2.5 years). Refractive errors ranged from +1.5 to -9.75 diopters (D) (mean: +1.83 +/- 2.74 D) with up to 1.75 D cylinder (mean: 0.58 +/- 0.53 D). Three readings were collected per instrument by one examiner without anticholinergic agents. Refraction values were decomposed into vector components for analysis, resulting in mean spherical equivalent refraction (M) and J0 and J45 being vectors of cylindrical power at 0 degrees and 45 degrees, respectively. RESULTS: Positive correlation was observed between wavefront analyzers and the SRW-5000 for spherical equivalent refraction (OPD-Scan, r=0.959, P<.001; WASCA, r=0.981, P<.001; Allegretto, r=0.942, P<.001). Mean differences and limits of agreement showed more negative spherical equivalent refraction with wavefront analyzers (OPD-Scan, 0.406 +/- 0.768 D [range: 0.235 to 0.580 D] [P<.001]; WASCA, 0.511 +/- 0.550 D [range: 0.390 to 0.634 D] [P<.001]; and Allegretto, 0.434 +/- 0.904 D [range: 0.233 to 0.635 D] [P<.001]). A second analysis eliminating outliers showed the same trend but lower differences: OPD-Scan (n=75), 0.24 +/- 0.41 D (range: 0.15 to 0.34 D) (P<.001); WASCA (n=78), 0.46 +/- 0.47 D (range: 0.36 to 0.57 D) (P<.001); and Allegretto (n=77), 0.30 +/- 0.62 D (range: 0.16 to 0.44 D) (P<.001). No statistically significant differences were noted for J0 and J45. CONCLUSIONS: Wavefront analyzer refraction resulted in 0.30 D more myopia compared to SRW-5000 refraction in eyes without cycloplegia. This is the result of the accommodation excess attributable to instrument myopia. For the relatively low degrees of astigmatism in this study (<2.0 D), good agreement was noted between wavefront analyzers and the SRW-5000.

Adult↗
PubMed2005

Target spatial frequency determines the response to conflicting defocus- and convergence-driven accommodative stimuli.

Asthenopia, or visual fatigue, is a frequent complaint from observers of stereoscopic three-dimensional displays. It has been proposed that asthenopia is a consequence of anomalous oculomotor responses generated by conflict between accommodative and convergence stimuli. The hypothesis was examined by measuring accommodation and convergence continuously with a Shin-Nippon SRW5000 infrared autorefractor and a limbus tracking device. Subjects viewed a high contrast Maltese Cross target at three levels of Gaussian filter target blur under conditions of relatively low- and high-conflict between accommodation and convergence stimuli, the latter inducing the sensation of stereopsis. Under the low-conflict conditions accommodation was stable, but convergence-driven accommodation was dominant when the target was extremely blurred. Under the high-conflict conditions the role of convergence-driven accommodation increased systematically with the degree of target blur. It is proposed that defocus-driven accommodation becomes weak when the target comprises low spatial frequency components. Large accommodative overshoots to step stimuli that are not blurred or only mildly blurred were consistently observed and are attributed to the initial accommodative response being convergence-driven. Whereas the possibility that high-conflict conditions are a cause of asthenopia has been previously reported, this is the first evidence that they specifically affect accommodative responses while viewing stereoscopic displays.

Accommodation, Ocular↗
PubMed2005

Sympathetic innervation of ciliary muscle and oculomotor function in emmetropic and myopic young adults.

PURPOSE: Evidence exists for an additional inhibitory accommodative control system mediated by the sympathetic branch of the autonomic nervous system (ANS). This work aims to show the relative prevalence of sympathetic inhibition in young emmetropic and myopic adults, and to evaluate the effect of sympathetic facility on accommodative and oculomotor function. METHODS: Profiling of ciliary muscle innervation was carried out in 58 young adult subjects (30 emmetropes, 14 early onset myopes, 14 late onset myopes) by examining post-task open-loop accommodation responses, recorded continuously by a modified open-view infrared optometer. Measurements of amplitude of accommodation, tonic accommodation, accommodative lag at near, AC/A ratio, and heterophoria at distance and near were made to establish a profile of oculomotor function. RESULTS: Evidence of sympathetic inhibitory facility in ciliary smooth muscle was observed in 27% of emmetropes, 21% of early-onset myopes and 29% of late-onset myopes. Twenty-six percent of all subjects demonstrated access to sympathetic facility. Closed-loop oculomotor function did not differ significantly between subjects with sympathetic facility, and those with sympathetic deficit. CONCLUSIONS: Emmetropic and myopic groups cannot be distinguished in terms of the relative proportions having access to sympathetic inhibition. Presence of sympathetic innervation does not have a significant effect on accommodative function under closed-loop viewing conditions.

Accommodation, Ocular↗
PubMed2005

Ametropia and ocular biometry in a U.K. university student population.

PURPOSE: The prevalence of myopia is known to vary with age, ethnicity, level of education, and socioeconomic status, with a high prevalence reported in university students and in people from East Asian countries. This study determines the prevalence of ametropia in a mixed ethnicity U.K. university student population and compares associated ocular biometric measures. METHODS: Refractive error and related ocular component data were collected on 373 first-year U.K. undergraduate students (mean age = 19.55 years +/- 2.99, range = 17-30 years) at the start of the academic year at Aston University, Birmingham, and the University of Bradford, West Yorkshire. The ethnic variation of the students was as follows: white 38.9%, British Asian 58.2%, Chinese 2.1%, and black 0.8%. Noncycloplegic refractive error was measured with an infrared open-field autorefractor, the Shin-Nippon NVision-K 5001 (Shin Nippon, Ryusyo Industrial Co. Ltd, Osaka, Japan). Myopia was defined as a mean spherical equivalent (MSE) less than or equal to -0.50 D. Hyperopia was defined as an MSE greater than or equal to +0.50 D. Axial length, corneal curvature, and anterior chamber depth were measured using the Zeiss IOLMaster (Carl Zeiss, Jena, GmBH). RESULTS: The analysis was carried out only for white and British Asian groups. The overall distribution of refractive error exhibited leptokurtosis, and prevalence levels were similar for white and British Asian (the predominant ethnic group) students across each ametropic group: myopia (50% vs. 53.4%), hyperopia (18.8% vs. 17.3%), and emmetropia (31.2% vs. 29.3%). There were no significant differences in the distribution of ametropia and biometric components between white and British Asian samples. CONCLUSION: The absence of a significant difference in refractive error and ocular components between white and British Asian students exposed to the same educational system is of interest. However, it is clear that a further study incorporating formal epidemiologic methods of analysis is required to address adequately the recent proposal that juvenile myopia develops principally from "myopiagenic" environments and is relatively independent of ethnicity.

Adolescent↗
PubMed2005

Refractive and biometric changes with silicone hydrogel contact lenses.

PURPOSE: This study reports data from an 18-month longitudinal study of neophyte contact lens wearers and compares changes in ocular refraction and biometry induced by daily wear and continuous wear of two different silicone hydrogel (SiH) materials. METHODS: Forty-five subjects were enrolled in the study and randomly assigned to wear one of the two silicone hydrogel materials: Lotrafilcon A or Balafilcon A lenses on either a daily or continuous wear basis. Measurements of objective refraction, axial length, anterior chamber depth, corneal curvature, and the rate of peripheral corneal flattening were performed before and 1, 3, 6, 12, and 18 months after initial fitting. RESULTS: Mean spherical equivalent refractive error increased in the myopic direction in all contact lens groups across time (p < 0.001). Axial length was the main biometric contributor to the development of myopia. After 18 months of lens wear, subjects in the Lotrafilcon A group showed the greater mean increase in myopia (i.e., -0.50 D). CONCLUSIONS: The results of this study show that increases in myopia, similar if not higher than those found to occur normally in young adult noncontact lens wearers, still occur with silicone hydrogel contact lens wear. The main biometric contributor to the progression of myopia was an increase in axial length. Differences between our results and those of previous studies with silicone hydrogel contact lenses could be attributed to the differing populations used in which both age and occupation may have played a role.

Adult↗
PubMed2005

The use of correlation and regression methods in optometry.

Correlation and regression are two of the statistical procedures most widely used by optometrists. However, these tests are often misused or interpreted incorrectly, leading to erroneous conclusions from clinical experiments. This review examines the major statistical tests concerned with correlation and regression that are most likely to arise in clinical investigations in optometry. First, the use, interpretation and limitations of Pearson's product moment correlation coefficient are described. Second, the least squares method of fitting a linear regression to data and for testing how well a regression line fits the data are described. Third, the problems of using linear regression methods in observational studies, if there are errors associated in measuring the independent variable and for predicting a new value of Y for a given X, are discussed. Finally, methods for testing whether a non-linear relationship provides a better fit to the data and for comparing two or more regression lines are considered.

Humans↗
PubMed2005

Cognition, ocular accommodation, and cardiovascular function in emmetropes and late-onset myopes.

PURPOSE: To investigate objectively and noninvasively the role of cognitive demand on autonomic control of systemic cardiovascular and ocular accommodative responses in emmetropes and myopes of late-onset. METHODS: Sixteen subjects (10 men, 6 women) aged between 18 and 34 years (mean +/- SD: 22.6 +/- 4.4 years), eight emmetropes (EMMs; mean spherical equivalent [MSE] refractive error +/- SD: 0.05 +/- 0.24 D) and eight with late-onset myopia (LOMs; MSE +/- SD: -3.66 +/- 2.31 D) participated in the study. Subjects viewed stationary numerical digits monocularly within a Badal optical system (at both 0.0 and -3.0 D) while performing a two-alternative, forced-choice paradigm that matched cognitive loading across subjects. Five individually matched cognitive levels of increasing difficulty were used in random order for each subject. Five 20-second, continuous-objective recordings of the accommodative response measured with an open-view infrared autorefractor were obtained for each cognitive level, whereas simultaneous measurement of heart rate was continuously recorded with a finger-mounted piezoelectric pulse transducer for 5 minutes. Fast Fourier transformation of cardiovascular function allowed the relative power of the autonomic components to be assessed in the frequency domain, whereas heart period gave an indication of the time-domain response. RESULTS: Increasing the cognitive demand led to a significant reduction in the accommodative response in all subjects (0.0 D: by -0.35 +/- 0.33 D; -3.0 D: by -0.31 +/- 0.40 D, P < 0.001). The greater lag of LOMs compared with EMMs was not significant (P = 0.07) at both distance (0.38 +/- 0.35 D) and near (0.14 +/- 0.42 D). Mean heart period reduced with increasing levels of workload (P < 0.0005). LOMs exhibited a relative elevation in sympathetic system activity compared to EMMs. Within refractive groups, however, accommodative shifts with increasing cognition correlated with parasympathetic activity (r = 0.99, P < 0.001), more than with sympathetic activity (r = 0.62, P > 0.05). CONCLUSIONS: In an equivalent workload paradigm, increasing cognitive demand caused a reduction in accommodative response that was attributable principally to a concurrent reduction in the relative power of the parasympathetic component of the autonomic nervous system (ANS). The disparity in accommodative response between EMMs and LOMs, however, appears to be augmented by changes in the sympathetic nervous component of the systemic ANS.

Accommodation, Ocular↗
PubMed2004

Myopia: precedents for research in the twenty-first century.

The myopic eye is generally considered to be a vulnerable eye and, at levels greater than 6 D, one that is especially susceptible to a range of ocular pathologies. There is concern therefore that the prevalence of myopia in young adolescent eyes has increased substantially over recent decades and is now approaching 10-25% and 60-80%, respectively, in industrialized societies of the West and East. Whereas it is clear that the major structural correlate of myopia is longitudinal elongation of the posterior vitreous chamber, other potential correlates include profiles of lenticular and corneal power, the relationship between longitudinal and transverse vitreous chamber dimensions and ocular volume. The most potent predictors for juvenile-onset myopia continue to be a refractive error </=+0.50 D at 5 years of age and family history. Significant and continuing progress is being made on the genetic characteristics of high myopia with at least four chromosomes currently identified. Twin studies and genetic modelling have computed a heritability index of at least 80% across the whole ametropic continuum. The high index does not, however, preclude an environmental precursor, sustained near work with high cognitive demand being the most likely. The significance of associations between accommodation, oculomotor dysfunction and human myopia is equivocal despite animal models that have demonstrated that sustained hyperopic defocus can induce vitreous chamber growth. Recent optical and pharmaceutical approaches to the reduction of myopia progression in children are likely precedents for future research, for example progressive addition spectacle lens trials and the use of the topical M1 muscarinic antagonist pirenzepine.

Animals↗
PubMed2004

Clinical characteristics of unilateral myopic anisometropia in a juvenile optometric practice population.

PURPOSE: A retrospective study of longitudinal case histories, undertaken to establish the clinical and statistical characteristics of unilateral myopic anisometropia (UMA) amongst the juvenile and adolescent population at an optometric practice, is reported. UMA was defined as that specific refractive state where an unequivocally myopic eye is paired with a 'plano' [spherical equivalent refraction, (SER) = +/-0.25 Dioptres (D)] companion eye. METHODS: The clinical records of all patients aged <19 years on file at an established independent optometric practice were categorised as 'myopic' (SER < or =-0.50 D), 'hypermetropic' (> or =+0.75 D) or 'emmetropic' (> or =-0.37< or =+0.62 D). Subsequently all juvenile patients matching the UMA criterion, together with a case-matched group of bilaterally myopic individuals, were selected as the comparative study populations. RESULTS: A total of 14.4% (n = 21 of 146) of the juvenile myopic case histories were identified as cases of UMA. More than half of these UMA cases emerged between the ages of 11.5 and 13.5 years. There was a marked female gender bias. The linear gradient of the age-related mean refractive trend in the myopic eye of the UMA population was not statistically significantly different (p > 0.1) to that fitted to the ametropic progression recorded in either eye of the case-matched population of young bilateral myopes; uniquely the slope associated with the companion eye of UMA cases was statistically significantly (p < 0.025) less steep. Compared with bilateral myopes fewer cases of UMA required a refractive correction to relieve visual or asthenopic symptoms, and this initial correction was dispensed on average 1 year later (at age 12.7 years) in UMA patients. CONCLUSIONS: Individuals identified as demonstrating clinically-defined UMA can be considered as distinct but functionally normal cases on the continuum of human refractive error. However, any unilaterally-acting determining factor(s) underlying the genesis of the condition remain obscure.

Adolescent↗
PubMed2004

School vision screening, ages 5-16 years: the evidence-base for content, provision and efficacy.

The optometric profession in the UK has a major role in the detection, assessment and management of ocular anomalies in children between 5 and 16 years of age. The role complements a variety of associated screening services provided across several health care sectors. The review examines the evidence-base for the content, provision and efficacy of these screening services in terms of the prevalence of anomalies such as refractive error, amblyopia, binocular vision and colour vision and considers the consequences of their curtailment. Vision screening must focus on pre-school children if the aim of the screening is to detect and treat conditions that may lead to amblyopia, whereas if the aim is to detect and correct significant refractive errors (not likely to lead to amblyopia) then it would be expedient for the optometric profession to act as the major provider of refractive (and colour vision) screening at 5-6 years of age. Myopia is the refractive error most likely to develop during primary school presenting typically between 8 and 12 years of age, thus screening at entry to secondary school is warranted. Given the inevitable restriction on resources for health care, establishing screening at 5 and 11 years of age, with exclusion of any subsequent screening, is the preferred option.

Adolescent↗
PubMed2004

Posterior retinal contour in adult human anisomyopia.

PURPOSE: It is well documented that myopia is associated with an increase in axial length or, more specifically, in vitreous chamber depth. Whether the transverse dimensions of the eye also increase in myopia is relevant to further understanding of its development. METHODS: The posterior retinal surface was localized in two-dimensional space in both eyes of young adult white and Taiwanese-Chinese iso- and anisomyopes (N = 56), from measured keratometry, A-scan ultrasonography, and central and peripheral refraction (+/-35 degrees) data, with the aid of a computer modeling program designed for this purpose. Anisomyopes had 2 D or more interocular difference in their refractive errors, with mean values in their more myopic eyes of -5.57 D and in their less myopic eyes of -3.25 D, similar to the means of the two isomyopic groups. The derived retinal contours for the more and less myopic eyes were compared by way of investigating ocular shape changes that accompany myopia, in the posterior region of the vitreous chamber. The presence and size of optic disc crescents were also investigated as an index of retinal stretching in myopia. RESULTS: Relative to the less myopic eyes of anisometropic subjects, the more myopic eyes were more elongated and also distorted into a more prolate shape in both the white and Chinese groups. However, the Chinese eyes showed a greater and more uniform relative expansion of the posterior retinal surface in their more myopic eyes, and this was associated with larger optic disc crescents. The changes in the eyes of whites displayed a nasal-temporal axial asymmetry, reflecting greater enlargement of the nasal retinal sector. CONCLUSIONS: Myopia is associated with increased axial length and a prolate shape. This prolate shape is consistent with the proposed idea that axial and transverse dimensions of the eye are regulated differently. The observations that ocular shape changes are larger but more symmetrical in Chinese eyes than in eyes of whites warrant further investigation.

Adolescent↗
PubMed2003

A longitudinal study of vergence adaptation in incipient presbyopia.

BACKGROUND: To investigate vergence adaptation during the incipient phase of presbyopia, when the amplitude of accommodation approaches the level where the first reading addition is required. The study aimed to assess the ability of the vergence system to counteract changes in the component contributions to the overall vergence response with the decline in the amplitude of accommodation in presbyopia, although previous reports on the nature of changes in accommodative, tonic and proximal vergence are equivocal. METHODS: Using a 'flashed' Maddox rod technique, an assessment of vergence adaptation to 6delta base-out and 6delta base-in prism was made for 28 subjects (aged 35-45 years at the commencement of the study). The measurements were taken four times over a 2-year period. RESULTS: Using a repeated measures analysis of variance, the results show that with the decline in amplitude of accommodation, there is a statistically significant reduction in the magnitude of vergence adaptation to both base-out (p < 0.05) and base-in prism (p < 0.01). CONCLUSIONS: This study shows that with ageing, there is a decrease in the ability of the slow vergence mechanism to overcome a change in fusional vergence demand and would suggest that either the fast component of fusional vergence must cope with any change in fusional vergence demand or that the sum of the accommodative, tonic and proximal vergence responses are virtually stable with age.

Accommodation, Ocular↗