Accommodative Exercises to Lower Intraocular Pressure

Abstract

Purpose. This study investigated how a conscious change in ocular accommodation affects intraocular pressure (IOP) and ocular biometrics in healthy adult volunteers of different ages. Methods. Thirty-five healthy volunteers without ocular disease or past ocular surgery, and with refractive error between −3.50 and +2.50 diopters, were stratified into 20, 40, and 60 year old (y.o.) age groups. Baseline measurements of central cornea thickness, anterior chamber depth, anterior chamber angle, cornea diameter, pupil size, and ciliary muscle thickness were made by autorefraction and optical coherence tomography (OCT), while IOP was measured by pneumotonometry. Each subject’s right eye focused on a target 40 cm away. Three different tests were performed in random order: (1) 10 minutes of nonaccommodation (gazing at the target through lenses that allowed clear vision without accommodating), (2) 10 minutes of accommodation (addition of a minus 3 diopter lens), and (3) 10 minutes of alternating between accommodation and nonaccommodation (1-minute intervals). IOP was measured immediately after each test. A 20-minute rest period was provided between tests. Data from 31 subjects were included in the study. ANOVA and paired t-tests were used for statistical analyses. Results. Following alternating accommodation, IOP decreased by 0.7 mmHg in the right eye when all age groups were combined ( p = 0.029). Accommodation or nonaccommodation alone did not decrease IOP. Compared to the 20 y.o. group, the 60 y.o. group had a thicker ciliary muscle within 75 μm of the scleral spur, a thinner ciliary muscle at 125–300 μm from the scleral spur, narrower anterior chamber angles, shallower anterior chambers, and smaller pupils during accommodation and nonaccommodation ( p ’s < 0.01). Conclusion. Alternating accommodation, but not constant accommodation, significantly decreased IOP. This effect was not lost with aging despite physical changes to the aging eye. A greater accommodative workload and/or longer test period may improve the effect.

Comparison Between an Intraocular Lens With Extended Depth of Focus (Tecnis Symfony ZXR00) and a New Monofocal Intraocular Lens With Enhanced Intermediate Vision (Tecnis Eyhance ICB00)

“…This finding was also demonstrated in an earlier study comparing ZXR00 (61.6 AE 13.4, range; 31 to 80 years) and ICB00 (70.5 AE 8.0, range; 53 to 80 years). 23 Pupil size may decrease with age, 48,49 which can affect depth of focus and near vision. Therefore, there is a need for a study in which there is no age difference between the 2 groups.…”

Dynamic changes of scleral spur length in different accommodation stimuli states

“…Compared with static accommodation, the repeated accommodation did not induce a statistically significant IOP drop 14 . Stokkermans TJ et al also reported that alternating accommodation significantly decreased IOP and a greater accommodative workload and/or longer test period may improve the effect 32 . All the results suggest that IOP may decrease with accommodation.…”

Modern aspects of diagnosis and treatment of subjective manifestations and accommodation disorders in patients — professional users of personal computers (systematic review)

“…По результатам исследований, наряду с качественной оценкой цветовой палитры аккомодограммы, разработаны базовые количественные показатели, обес печивающие клиническое нормирование как правило, с помощью аппарата «Визотроник М3» («Добродар», Россия). Важно обязательное продолжение тренировочного процесса в домашних условиях с использованием специальных тренажёров, что, по мнению авторов, обеспечивает увеличение амплитуды монокулярной аккомодации и существенно повышает аккомодационный ответ [62][63][64].…”