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Accommodation and presbyopia

D A Atchison1

  • 1Centre for Eye Research, School of Optometry, Queensland University of Technology, Red Hill Q, Australia.

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)
|July 1, 1995
PubMed
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Presbyopia, or age-related farsightedness, results from declining eye accommodation. This study finds little evidence supporting the Hess-Gullstrand theory, suggesting ciliary muscle changes are not a primary cause of presbyopia.

Area of Science:

  • Ophthalmology
  • Physiology
  • Gerontology

Background:

  • The mechanism of visual accommodation, the eye's ability to focus on near objects, has been studied for centuries.
  • Accommodation declines with age, leading to presbyopia, a condition affecting close-up vision.
  • Presbyopia is generally attributed to changes in the lens, capsule, or supporting structures of the eye.

Purpose of the Study:

  • To review current understanding of accommodation mechanisms and presbyopia theories.
  • To evaluate the validity of the Hess-Gullstrand theory of presbyopia.
  • To determine the role of ciliary muscle contractility in presbyopia development.

Main Methods:

  • Literature review of existing research on accommodation and presbyopia.
  • Analysis of theories explaining the decline in accommodative ability with age.

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  • Critical evaluation of the Hess-Gullstrand theory based on available evidence.
  • Main Results:

    • The Hess-Gullstrand theory posits that increased ciliary muscle contraction occurs with age, exceeding the lens and capsule's response.
    • Alternative theories suggest maximum ciliary muscle contraction is required for maximum accommodation beyond a certain age.
    • Evidence overwhelmingly contradicts the Hess-Gullstrand theory.

    Conclusions:

    • The Hess-Gullstrand theory is not supported by current scientific evidence.
    • Changes in ciliary muscle contractility are unlikely to be a significant factor in the development of presbyopia.
    • Further research should focus on other mechanisms within the accommodative system, such as lens and capsule changes.