title: [Monochromatic aberration in accommodation. Dynamic wavefront analysis].
abstract: BACKGROUND
  Monochromatic aberrations may influence the visual acuity of the eye. They are not stable and can be affected by different factors. The subject of the following paper is the dynamic investigation of the changes in wavefront aberration with accommodation.
  
  
  METHODS
  Dynamic measurement of higher and lower order aberrations was performed with a WASCA Wavefront Analyzer (Carl-Zeiss-Meditec) and a specially constructed target device for aligning objects in far and near distances on 25 subjects aged from 15 to 27 years old.
  
  
  RESULTS
  Wavefront aberrations showed some significant changes in accommodation. In addition to the characteristic sphere reaction accompanying miosis and changes in horizontal prism (Z(1) (1)) in the sense of a convergence movement of the eyeball also occurred. Furthermore defocus rose (Z(2) (0)) and astigmatism (Z(2) (-2)) changed. In higher-order aberrations a decrease in coma-like Zernike polynomials (Z(3) (-1), Z(3) (1)) was found. The most obvious change appeared in spherical aberration (Z(4) (0)) which increased and changed from positive to negative. In addition the secondary astigmatism (Z(4) (-2)) and quadrafoil (Z(4) (4)) rise also increased. The total root mean square (RMS), as well as the higher-order aberrations (RMS-HO) significantly increased in accommodation which is associated with a theoretical reduction of visual acuity. An analysis of the influence of pupil size on aberrations showed significant increases in defocus, spherical aberration, quadrafoil, RMS and RMS HO by increasing pupil diameter. By accommodation-associated miosis, the growing aberrations are partially compensated by focusing on near objects. Temporal analysis of the accommodation process with dynamic wavefront analysis revealed significant delays in pupil response and changing of prism in relation to the sphere reaction. In accommodation to near objects a discrete time ahead of third order aberrations in relation to the sphere response was found.
  
  
  CONCLUSIONS
  Using dynamic wavefront measurement achieved a sequential analysis of aberrations during accommodation. Significant changes in the lower and higher-order aberrations could be detected. These are additionally varied by the associated pupillary response. Moreover, the synchronicity of wave front reaction in the accommodation process was proven.
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum Jena, Jena, Germany. marcusfritzsch@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Fritzsch
authors.forename: J
authors.initials: J
authors.lastname: Dawczynski
authors.forename: S
authors.initials: S
authors.lastname: Jurkutat
authors.forename: R
authors.initials: R
authors.lastname: Vollandt
authors.forename: J
authors.initials: J
authors.lastname: Strobel
mesh_terms: D000065:Accommodation, Ocular; D001251:Astigmatism / Q000175:diagnosis*; D015350:Contrast Sensitivity; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000175:diagnosis*; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D012030:Refractive Errors / Q000175:diagnosis*; D014792:Visual Acuity