Changes in accommodation with age: static and dynamic.

Abstract

Accommodative amplitude decreases with age, not with aging. The decrease is largely completed by age 40 years; only minor residual accommodation is present in most subjects after the mid-40s. Dynamical measurements show the accommodative response of subjects over 30 years of age to be significantly slowed (time constants of accommodation increases). Accommodation amplitude is less than 3 D by 30 years of age. Thus prepresbyopia is a sign of continual development, not of deterioration of the accommodative mechanism. Accommodation, or the change of clear vision with change in lens power, has been studied by many distinguished scientists including Descartes and Thomas Young. Helmholtz's "Theory of Accommodation" is a dual, indirect, active theory. There are both lenticular, including lens and capsule, and also extralenticular mechanisms, comprised of the zonule of Zinn or suspensory ciliary ligament and the ciliary muscle itself. The ciliary muscle does not act directly on the lens but indirectly through its action on the zonule of Zinn. Active contraction of the ciliary muscle, a unified muscle, produces accommodation; relaxation of the ciliary muscle permits relaxation of accommodation.