Accommodative error, adaptation and myopia

Accommodative adaptation, resulting from the sustained output of slow blur-driven accommodation during the course of a sustained near-vision task, has generally been assessed under open-loop conditions. This study examined whether adaptation influences closed-loop accommodation during the course of a sustained near-vision task. Accommodative adaptation was assessed in 18 fully-corrected subjects by comparing pre- and post-task values of dark accommodation recorded objectively with an infra-red optometer. Subjects performed a continuous 10 min binocular near-vision task at a viewing distance of 33 cm, with the within-task accommodative response being assessed at 1 min intervals during this period. Subjects were categorized into adaptors (N = 11) and non-adaptors (N = 7) on the basis of whether their initial 10 sec post-task adaptation exceeded +0.30D. The adapting group exhibited a significant decline in the lag of accommodation during the first 3 min of the near-task, whereas no significant change in the within-task response over time was observed in the non-adapting group. These results indicate that accommodative adaptation increases the accuracy of the within-task, closed-loop accommodative response. Furthermore, we speculate that a deficit in accommodative adaptation, being accompanied by increased retinal defocus during near fixation, may contribute to the development of nearwork-induced myopia.