Accommodation and presbyopia

Atchison, David A. (1995) Accommodation and presbyopia. Ophthalmic and Physiological Optics, 15(4), pp. 255-272.

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The mechanism of accommodation has been studied for at least four hundred years. The most interesting aspect of accommodation is that its time course is well in advance of other physiological functions – it begins to decline by adolescence and is lost about two-thirds of the way through the normal life span. The state of presbyopia is reached when accommodation has declined sufficiently to interfere with close tasks requiring acute vision. Presbyopia is generally considered to originate with the ‘plant’ of the accommodative system, either within the lens and its capsule or within their support structures. One of the lenticular theories, the Hess-Gullstrand theory, is distinguished from other theories by its claim that as age increases there is an increasing excess amount of ciliary muscle contraction beyond the ability of the lens and capsule to respond to it. For all other theories, the maximum possible amount of ciliary muscle contraction is always necessary to produce maximum accommodation, at least beyond the age at which it reaches its peak. From my review of the present understanding of the mechanism of accommodation and the theories of the development of presbyopia, I conclude that there is overwhelming evidence against the Hess-Gullstrand theory and that it is unlikely that changes in the ciliary muscle contractility contribute significantly to the development of presbyopia.

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ID Code: 5111
Item Type: Journal Article
Refereed: Yes
Additional Information: For more information, please refer to the journal’s website (see link) or contact the author. Author contact details:
Keywords: accommodation, presbyopia, age
DOI: 10.1046/j.1475-1313.1995.9500020e.x
ISSN: 0275-5408
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 1995 Blackwell Publishing
Copyright Statement: The definitive version is available at
Deposited On: 27 Sep 2006 00:00
Last Modified: 15 Jan 2009 07:12

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