Accommodative and binocular characteristics in myopes with age-related accommodation deficiency

Abstract Background To investigate accommodative and binocular characteristics in myopic patients with age-related accommodation deficiency, and to investigate the relationship of accommodation amplitude (AA) with other accommodative and binocular parameters. Methods Myopic patients between 40 and 5...

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Main Authors: Ruiyu Zhang, Yifei Yuan, Yu Zhang, Yueguo Chen
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03938-8
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author Ruiyu Zhang
Yifei Yuan
Yu Zhang
Yueguo Chen
author_facet Ruiyu Zhang
Yifei Yuan
Yu Zhang
Yueguo Chen
author_sort Ruiyu Zhang
collection DOAJ
description Abstract Background To investigate accommodative and binocular characteristics in myopic patients with age-related accommodation deficiency, and to investigate the relationship of accommodation amplitude (AA) with other accommodative and binocular parameters. Methods Myopic patients between 40 and 50 years old to undergo refractive surgery were enrolled. Accommodative function, including AA, positive and negative relative accommodation (PRA and NRA), accommodative response (binocular cross cylinder, BCC), and binocular accommodative facility (BAF) were examined. Binocular vision measurements including simultaneous perception, fusional vergence, and stereovision assessed with a synoptophore. Near point of convergence (NPC) and the gradient accommodative convergence/accommodation (AC/A) ratio were also measured. A questionnaire was used to assess subjective visual discomfort experienced after prolonged near work. Results A total of 145 subjects were evaluated, with a mean age of 42.59 ± 2.89 (SD) years. In the full data set, 96(66.21%) of patients had PRA (>-1.50 D), 21(14.48%) of patients had NRA (< 1.50 D), and 113(77.93%) of patients had BCC (< 0.25 D). Out of 97 patients, 17(17.53%) had AC/A (< 2), 54(55.67%) had NPC (> 7.5 cm), 51(52.58%) had BAF (< 5 cpm). As for the simultaneous perception, 59(60.82%) had values greater than 0 prism dioptres. Adjusting for associated factors, participants with lower AA were more likely to be older (odds ratio [OR], 2.080; 95% confidence interval [CI], 1.523–2.841) and with milder myopia (OR, 1.280; 95% CI, 1.029–1.594). Lower BAF (OR, 4.990; 95% CI, 1.731–14.386) was more likely to be found in individuals with lower AA. The three most commonly reported visual discomforts were eye strain or soreness, ocular pain or headache, and blurred text. Conclusion For myopes at the early stage of presbyopia, the continuous tension in the vergence system was also worthy of our attention, in addition to the well-known AA insufficiency. Comprehensive assessment of the binocular status and appropriate management is recommended before and after corneal refractive surgery.
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spelling doaj-art-dd0a0ae366aa4bee9be57f8742656ecc2025-08-20T02:59:19ZengBMCBMC Ophthalmology1471-24152025-03-012511810.1186/s12886-025-03938-8Accommodative and binocular characteristics in myopes with age-related accommodation deficiencyRuiyu Zhang0Yifei Yuan1Yu Zhang2Yueguo Chen3Department of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalDepartment of Ophthalmology, Peking University Third HospitalAbstract Background To investigate accommodative and binocular characteristics in myopic patients with age-related accommodation deficiency, and to investigate the relationship of accommodation amplitude (AA) with other accommodative and binocular parameters. Methods Myopic patients between 40 and 50 years old to undergo refractive surgery were enrolled. Accommodative function, including AA, positive and negative relative accommodation (PRA and NRA), accommodative response (binocular cross cylinder, BCC), and binocular accommodative facility (BAF) were examined. Binocular vision measurements including simultaneous perception, fusional vergence, and stereovision assessed with a synoptophore. Near point of convergence (NPC) and the gradient accommodative convergence/accommodation (AC/A) ratio were also measured. A questionnaire was used to assess subjective visual discomfort experienced after prolonged near work. Results A total of 145 subjects were evaluated, with a mean age of 42.59 ± 2.89 (SD) years. In the full data set, 96(66.21%) of patients had PRA (>-1.50 D), 21(14.48%) of patients had NRA (< 1.50 D), and 113(77.93%) of patients had BCC (< 0.25 D). Out of 97 patients, 17(17.53%) had AC/A (< 2), 54(55.67%) had NPC (> 7.5 cm), 51(52.58%) had BAF (< 5 cpm). As for the simultaneous perception, 59(60.82%) had values greater than 0 prism dioptres. Adjusting for associated factors, participants with lower AA were more likely to be older (odds ratio [OR], 2.080; 95% confidence interval [CI], 1.523–2.841) and with milder myopia (OR, 1.280; 95% CI, 1.029–1.594). Lower BAF (OR, 4.990; 95% CI, 1.731–14.386) was more likely to be found in individuals with lower AA. The three most commonly reported visual discomforts were eye strain or soreness, ocular pain or headache, and blurred text. Conclusion For myopes at the early stage of presbyopia, the continuous tension in the vergence system was also worthy of our attention, in addition to the well-known AA insufficiency. Comprehensive assessment of the binocular status and appropriate management is recommended before and after corneal refractive surgery.https://doi.org/10.1186/s12886-025-03938-8Accommodative functionBinocular visionAge-related accommodation deficiencyRefractive surgeryMonovision
spellingShingle Ruiyu Zhang
Yifei Yuan
Yu Zhang
Yueguo Chen
Accommodative and binocular characteristics in myopes with age-related accommodation deficiency
BMC Ophthalmology
Accommodative function
Binocular vision
Age-related accommodation deficiency
Refractive surgery
Monovision
title Accommodative and binocular characteristics in myopes with age-related accommodation deficiency
title_full Accommodative and binocular characteristics in myopes with age-related accommodation deficiency
title_fullStr Accommodative and binocular characteristics in myopes with age-related accommodation deficiency
title_full_unstemmed Accommodative and binocular characteristics in myopes with age-related accommodation deficiency
title_short Accommodative and binocular characteristics in myopes with age-related accommodation deficiency
title_sort accommodative and binocular characteristics in myopes with age related accommodation deficiency
topic Accommodative function
Binocular vision
Age-related accommodation deficiency
Refractive surgery
Monovision
url https://doi.org/10.1186/s12886-025-03938-8
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