Factors Influencing Pseudo-Accommodation—The Difference between Subjectively Reported Range of Clear Focus and Objectively Measured Accommodation Range


The key determinants of the range of clear focus in pre-presbyopes and their relative contributions to the difference between subjective range of focus and objective accommodation assessments have not been previously quantified. Fifty participants (aged 33.0 ± 6.4 years) underwent simultaneous monocular subjective (visual acuity measured with an electronic test-chart) and objective (dynamic accommodation measured with an Aston open-field aberrometer) defocus curve testing for lenses between +2.00 to −10.00 DS in +0.50 DS steps in a randomized order. Pupil diameter and ocular aberrations (converted to visual metrics normalized for pupil size) at each level of blur were measured. The difference between objective range over which the power of the crystalline lens changes and the subjective range of clear focus was quantified and the results modelled using pupil size, refractive error, tolerance to blur, and ocular aberrations. The subjective range of clear focus was principally accounted for by age (46.4%) and pupil size (19.3%). The objectively assessed accommodative range was also principally accounted for by age (27.6%) and pupil size (15.4%). Over one-quarter (26.0%) of the difference between objective accommodation and subjective range of clear focus was accounted for by age (14.0%) and spherical aberration at maximum accommodation (12.0%). There was no significant change in the objective accommodative response (F = 1.426, p = 0.229) or pupil size (F = 0.799, p = 0.554) of participants for levels of defocus above their amplitude of accommodation. Pre-presbyopes benefit from an increased subjective range of clear vision beyond their objective accommodation due in part to neural factors, resulting in a measured depth-of-focus of, on average, 1.0 D

Publication DOI: https://doi.org/10.3390/vision3030034
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
Additional Information: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
Publication ISSN: 0972-2629
Last Modified: 15 Jul 2024 07:56
Date Deposited: 08 Jul 2019 12:31
Full Text Link:
Related URLs: https://www.mdp ... 411-5150/3/3/34 (Publisher URL)
PURE Output Type: Article
Published Date: 2019-06-28
Accepted Date: 2019-06-20
Authors: Dhallu, Sandeep
Sheppard, Amy L (ORCID Profile 0000-0003-0035-8267)
Drew, Thomas E
Mihashi, Toshifumi
Zapata-Diaz, Juan F
Radhakrishnan, Hema
Iskander, D. Robert
Wolffsohn, James S. (ORCID Profile 0000-0003-4673-8927)



Version: Published Version

License: Creative Commons Attribution

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