Aberration control and vision training as an effective means of improving accommodation in individuals with myopia.
OBJECTIVE
To test the efficacy of a novel dual treatment for improving accommodative accuracy and dynamics in young persons with myopia.


METHODS
Ninety-three young persons with myopia (mean spherical equivalent, -3.0 +/- 1.8 D; age 16.8 +/- 2.1 years; spherical aberration +0.06 +/- 0.04 microm) participated in the study. Custom-designed soft contact lenses were used to alter ocular SA to -0.10 microm to improve accommodative accuracy and reduce any lag of accommodation. A vision training regimen was performed for 18 minutes per day for up to 6 weeks to improve speed of dynamic accommodation. Control groups had contact lenses with no added SA and/or no exercises. To avoid any effects of natural levels of negative aberration on the results of the study, all participants who had negative SA were excluded.


RESULTS
The treatment contact lenses produced a significant reduction in lag of accommodation (P < 0.05) at all proximal viewing distances measured. The vision training measurement and treatment resulted in a significant increase in distance facility rate for all groups compared with their own baselines (P < 0.05). Near facility rate improved in the vision training treatment group only compared with its baseline (P < 0.05). Both positive and negative response times for distant viewing were significantly shorter in all groups after training compared with their baseline values (P < 0.05). At near, the positive response times were decreased significantly (P < 0.05) in both groups, whereas the negative response times decreased significantly only in the vision training treatment group.


CONCLUSIONS
After 3 months, the dual treatments (altering SA and vision training) used in the study were effective in modifying accommodation. The static accommodative response to targets at proximal distances was increased by the altered SA contact lenses and rates of dynamic accommodation improved with vision training.
Allen
Peter M
PM
Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, United Kingdom. peter.allen@anglia.ac.uk
Radhakrishnan
Hema
H
Rae
Sheila
S
Calver
Richard I
RI
Theagarayan
Baskar Pitty
BP
Nelson
Paul
P
Osuobeni
Ebi
E
Sailoganathan
Ananth
A
Price
Holly
H
O'Leary
Daniel J
DJ
D000065:Accommodation, Ocular / Q000502:physiology*; D000221:Adaptation, Ocular / Q000502:physiology; D000293:Adolescent; D003263:Contact Lenses, Hydrophilic; D057108:Corneal Wavefront Aberration / Q000503:physiopathology / Q000628:therapy*; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000628:therapy*; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult