Amplitude of Accommodation for Different Head Positions and Different Directions of Eye Gaze

Atchison, David A., Claydon, Carol A., & Irwin, Susan E. (1994) Amplitude of Accommodation for Different Head Positions and Different Directions of Eye Gaze. Optometry and Vision Science, 71(5), pp. 339-345.


One of the theories of the mechanism of presbyopia is the Hess-Gullstrand theory. This theory predicts that amplitude of accommodation should increase in down-gaze because of movement of the lens under the influence of gravity, and that this should be more marked for older than for younger subjects. We assessed this theory by measuring the effect of direction of eye gaze and head posture on amplitude of accommodation for two age groups. Farpoints, nearpoints, and amplitude of accommodation were determined for two subject groups, a young group aged 18 to 25 years and an older group aged 35 to 45 years. Small but significant shifts of nearpoints toward the eye were observed when head position or eye gaze was shifted from above to below the horizontal, for the younger observers only (the maximum mean difference between conditions was 1.1 D, compared with a mean accommodation level of 9.8 D for this young group). Previous studies by others found changes in the same direction for eye gaze and head position, respectively, but our changes were much smaller. We do not believe that particular care is needed in selection of head position and eye gaze during clinical measurements of the amplitude of accommodation. Because the shift of the nearpoint was noted only for the younger group, this study does not support the Hess-Gullstrand theory of presbyopia.

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24 citations in Scopus
20 citations in Web of Science®
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ID Code: 5099
Item Type: Journal Article
Refereed: Yes
Additional Information: The contents of this journal can be freely accessed online via the journal’s web page (see link) 12 months after publication. For more information, please refer to the journal’s website (see link) or contact the author. Author contact details:
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Keywords: amplitude of accommodation, gaze direction, head position, Hess, Gullstrand theory
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
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 1994 Lippincott Williams & Wilkins
Deposited On: 28 Sep 2006 00:00
Last Modified: 15 Jan 2009 07:12

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