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Published on: March 3, 2023
Measurement of consensual accommodation in vision-impaired eyes
Pesala Veerendranath1, Les Donovan, Mukesh Taneja
1*BSc(Optom) †BOptom ‡DNB §PhD ∥BSc **MS ††PhD, FAAO L V Prasad Eye Institute, Hyderabad, India (PV, MT, VSS); Vision Cooperative Research Centre, Sydney, New South Wales, Australia (PV, MT, QG, SD, VSS); Brien Holden Vision Institute, New South Wales, Australia (LD, TJN, QG, SD, AH); School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia (QG, AH); and Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida (AH).
Purpose:
To measure the accommodative response in unsighted or profoundly vision impaired (PVI) eyes when accommodation is elicited in the fellow, sighted eye.
Methods:
Eighty-eight unilaterally PVI subjects (UPS) and 97 bilaterally sighted subjects (BSS) (10 to 45 years) were enrolled. Subjects had clear ocular media for auto-refraction and could steadily fixate targets with the sighted eye. For BSS, a long-pass filter was placed in front of one eye to simulate unilateral blindness. Both eyes were measured with a Shin-Nippon auto-refractor while fixating a 4/40 letter at 4 m and then an N8 letter at 40 cm and at 33 cm. Accommodation was calculated as the difference between distance and near refraction.
Results:
Only subjects with repeatable alignment between measurements were included in the analyses (64 UPS, 95 BSS). Results were analyzed using t test and a generalized linear mixed model including age, sightedness, distance spherical equivalent, and accommodation as factors. The t test found no significant difference between eyes for UPS (p = 0.981 at 40 cm and p = 0.663 at 33 cm). For BSS, the sighting eye produced statistically significant but only slightly greater amounts of accommodation than the filtered eye (0.098 diopters [D], p = 0.002 at 40 cm and 0.189 D, p < 0.001 at 33 cm). The generalized linear mixed model found no difference between BSS and UPS in terms of difference in accommodation between eyes (p = 0.128 at 40 cm and p = 0.157 at 33 cm).
Conclusions:
The PVI eyes of unilaterally PVI individuals display similar accommodative response to their fellow, sighted eyes when accommodation is elicited by near target of up to 3 D to the fellow eye. However, the difference in accommodative response between PVI and fellow, sighted eye is related to the amount of accommodation elicited.
