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Vision Res. 2017 Jan;130:9-21. doi: 10.1016/j.visres.2016.11.001. Epub 2016 Nov 29.

Are high lags of accommodation in myopic children due to motor deficits?

Author information

1
School of Optometry and Vision Science, University of Waterloo, Ontario N2L 3G1, Canada. Electronic address: vlabhish@uwaterloo.ca.
2
School of Optometry and Vision Science, University of Waterloo, Ontario N2L 3G1, Canada.

Abstract

Children with a progressing myopia exhibit an abnormal pattern of high accommodative lags coupled with high accommodative convergence (AC/A) and high accommodative adaptation. This is not predicted by the current models of accommodation and vergence. Reduced accommodative plant gain and reduced sensitivity to blur have been suggested as potential causes for this abnormal behavior. These etiologies were tested by altering parameters (sensory, controller and plant gains) in the Simulink model of accommodation. Predictions were then compared to the static and dynamic blur accommodation (BA) measures taken using a Badal optical system on 12 children (6 emmetropes and 6 myopes, 8-13years) and 6 adults (20-35years). Other critical parameters such as CA/C, AC/A, and accommodative adaptation were also measured. Usable BA responses were classified as either typical or atypical. Typical accommodation data confirmed the abnormal pattern of myopia along with an unchanged CA/C. Main sequence relationship remained invariant between myopic and nonmyopic children. An overall reduction was noted in the response dynamics such as peak velocity and acceleration with age. Neither a reduced plant gain nor reduced blur sensitivity could predict the abnormal accommodative behavior. A model adjustment reflecting a reduced accommodative sensory gain (ASG) coupled with an increased AC cross-link gain and reduced vergence adaptive gain does predict the empirical findings. Empirical measures also showed a greater frequency of errors in accommodative response generation (atypical responses) in both myopic and control children compared to adults.

KEYWORDS:

Atypical responses; Blur accommodation; Convergence accommodation; Double steps; Dynamic characteristics; Dynamic overshoots; Main sequence; Myopia

PMID:
27876513
DOI:
10.1016/j.visres.2016.11.001
[Indexed for MEDLINE]
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