The effect of common reductions in letter size and contrast on accommodation responses in young adult myopes and emmetropes

Schmid, Katrina L., Hilmer, Katherine S., Lawrence, Rebecca A., Loh, Shook-Yee, Morrish, Linda J., & Brown, Brian (2005) The effect of common reductions in letter size and contrast on accommodation responses in young adult myopes and emmetropes. Optometry and Vision Science, 82(7), pp. 602-611.


PURPOSE: Accommodation errors during reading and the subsequent near work-induced transient myopia (NITM) that occurs have been implicated in the development and progression of myopia. This study investigated the effects of two letter variables, size and contrast, on accommodation accuracy during the near task and on NITM and its subsequent decay. These were varied so as to mimic what might occur when students photocopy and reduce reading materials. METHODS: Based on their refractive errors, young adult subjects (18-25 years) were classified into three groups: emmetropes (n = 19), stable myopes (n = 17), and progressing myopes (n = 17). Three print sizes (N4, N6, and N8) and two print contrasts (90% and 60%) were used to give six different reading targets. Targets were presented in random order at 25 cm (4 D demand) and the text read for comprehension for 3 minutes. For each target, accommodation accuracy and NITM and its decay were measured using the free space Shin-Nippon SRW-5000 autorefractor. RESULTS: When data for all subjects were pooled, there was a significant effect of letter size (p = 0.030) but not contrast (p = 0.898) on accommodation accuracy; however, differences were small and unlikely to be clinically relevant. NITM (p = 0.033) and its decay (p = 0.012) also varied with letter size. NITM was greater and decay longer for larger letters. We found no effect of refractive error group on accommodation accuracy. In contrast, there was a significant difference in the magnitude of NITM and its decay for emmetropic and myopic subjects (although no effect of progression status); myopes had larger NITM values and longer decay times to baseline than emmetropes (NITM myopes: 0.37 +/- 0.14D vs. emmetropes: 0.19 +/- 0.17 D, p = 0.005; decay time myopes: 15.12 +/- 6.58 seconds vs. emmetropes 7.10 +/- 4.82 seconds, p = 0.0045). The differences in NITM and its decay between the two refractive groups were of similar magnitude for all six combinations of letter size and contrast. CONCLUSIONS: Our data do not support the suggestion that common reductions in letter size or contrast of reading material (as might occur for photocopied reading materials) cause greater accommodation inaccuracy and greater near work-induced adaptation effects that would exacerbate myopia development in young adults.

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10 citations in Web of Science®
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ID Code: 4275
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:
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Keywords: Accommodation, Ocular/, physiology, Contrast Sensitivity/, physiology, Myopia/, physiopathology, Adolescent, Adult, Comparative Study, Female, Humans, Male, Reading, Vision Tests, Vision, Binocular, Visual Acuity
ISSN: 1538-9235
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
Copyright Owner: Copyright 2005 Lippincott, Williams and Wilkins
Deposited On: 14 Jun 2006 00:00
Last Modified: 29 Feb 2012 13:15

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