Hyperopic eyes are structurally more dynamic than myopic eyes during accommodation: an in-vivo investigation

Tuyishime Didier Fidele Uwacu; Saugat Bhattacharyya; Kathryn J Saunders; Julie-Anne Little

doi:10.1167/iovs.66.6.51

Hyperopic eyes are structurally more dynamic than myopic eyes during accommodation: an in-vivo investigation

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Abstract

The impact of different refractive errors on accommodative structural changes remains unclear. Novel swept-source imaging technology in anterior segment optical coherence tomography (AS-OCT) has enabled in vivo investigation of the accommodating eye. This study investigated ocular structural change and corresponding functional responses during accommodation in individuals with emmetropia, myopia, and hyperopia. Adults (n = 46; mean age, 22.15 ± 3.00 years) with normal accommodation and a wide range of refractive errors (spherical equivalent refraction [SER]: -7.50 D to +7.88 D) were recruited. CASIA2 AS-OCT measured anterior segment changes during accommodation stimulated by the use of inbuilt accommodative targets and bespoke external stimuli at five different accommodative demands (0 D, 2 D, 3 D, 4 D, and 6 D) and under cycloplegia. Simultaneously, changes in refractive state were measured using the PowerRefractor3 photorefraction system. Lens thickness (LT), anterior chamber depth (ACD), lens diameter (LD), anterior segment length (ASL), anterior lens radius of curvature (ALRC), and posterior lens radius of curvature (PLRC) changed significantly during accommodation (all P < 0.001). Accommodative changes in LT, ACD, and ASL were significantly associated with the level of SER (all P < 0.05), as more hyperopic eyes showed significantly greater per-diopter change than myopic eyes in LT (P = 0.014) and ACD (P = 0.039) for comparatively similar accommodative response (P > 0.9). The analysis of lens position showed that cycloplegia induced posterior displacement of the lens. The CASIA2 internal accommodative target and the external proximal target induced similar structural and functional accommodative responses. There are significant differences between structural changes seen in accommodating eyes with different types and magnitudes of refractive error, with hyperopic eyes showing greater changes in LT and ACD than myopic eyes during accommodation.

Original language	English
Article number	51
Pages (from-to)	1-14
Number of pages	14
Journal	Investigative Ophthalmology and Visual Science
Volume	66
Issue number	6
Early online date	2 Jun 2025
DOIs	https://doi.org/10.1167/iovs.66.6.51
Publication status	Published (in print/issue) - 30 Jun 2025

Bibliographical note

Publisher Copyright:
Copyright 2025 The Authors.

Funding

The authors thank all participants who volunteered for this study. Supported by the Department of the Economy\u2019s Vice-Chancellor\u2019s Research Scholarship, Ulster University, Coleraine, United Kingdom (TDFU).

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Humans
Accommodation, Ocular/physiology
Hyperopia/physiopathology
Tomography, Optical Coherence/methods
Male
Female
Myopia/physiopathology
Young Adult
Adult
Refraction, Ocular/physiology
Anterior Eye Segment/diagnostic imaging
Emmetropia/physiology
Lens, Crystalline/physiopathology
Anterior Chamber/pathology
Hyperopia - physiopathology
Emmetropia - physiology
Anterior Eye Segment - diagnostic imaging - pathology - physiopathology
Tomography, Optical Coherence - methods
Anterior Chamber - pathology
Lens, Crystalline - physiopathology - pathology
Accommodation, Ocular - physiology
Myopia - physiopathology
Refraction, Ocular - physiology
OCT
anterior segment
CASIA2
cycloplegia
eye imaging
eye structure
hyperopia
accommodation
myopia
refractive error

Access to Document

10.1167/iovs.66.6.51

i1552-5783-66-6-51_1750067459.11802Final published version, 4.05 MBLicence: CC BY-NC-ND

Cite this

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title = "Hyperopic eyes are structurally more dynamic than myopic eyes during accommodation: an in-vivo investigation",

abstract = "The impact of different refractive errors on accommodative structural changes remains unclear. Novel swept-source imaging technology in anterior segment optical coherence tomography (AS-OCT) has enabled in vivo investigation of the accommodating eye. This study investigated ocular structural change and corresponding functional responses during accommodation in individuals with emmetropia, myopia, and hyperopia. Adults (n = 46; mean age, 22.15 ± 3.00 years) with normal accommodation and a wide range of refractive errors (spherical equivalent refraction [SER]: -7.50 D to +7.88 D) were recruited. CASIA2 AS-OCT measured anterior segment changes during accommodation stimulated by the use of inbuilt accommodative targets and bespoke external stimuli at five different accommodative demands (0 D, 2 D, 3 D, 4 D, and 6 D) and under cycloplegia. Simultaneously, changes in refractive state were measured using the PowerRefractor3 photorefraction system. Lens thickness (LT), anterior chamber depth (ACD), lens diameter (LD), anterior segment length (ASL), anterior lens radius of curvature (ALRC), and posterior lens radius of curvature (PLRC) changed significantly during accommodation (all P < 0.001). Accommodative changes in LT, ACD, and ASL were significantly associated with the level of SER (all P < 0.05), as more hyperopic eyes showed significantly greater per-diopter change than myopic eyes in LT (P = 0.014) and ACD (P = 0.039) for comparatively similar accommodative response (P > 0.9). The analysis of lens position showed that cycloplegia induced posterior displacement of the lens. The CASIA2 internal accommodative target and the external proximal target induced similar structural and functional accommodative responses. There are significant differences between structural changes seen in accommodating eyes with different types and magnitudes of refractive error, with hyperopic eyes showing greater changes in LT and ACD than myopic eyes during accommodation.",

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AU - Uwacu, Tuyishime Didier Fidele

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AU - Saunders, Kathryn J

AU - Little, Julie-Anne

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N2 - The impact of different refractive errors on accommodative structural changes remains unclear. Novel swept-source imaging technology in anterior segment optical coherence tomography (AS-OCT) has enabled in vivo investigation of the accommodating eye. This study investigated ocular structural change and corresponding functional responses during accommodation in individuals with emmetropia, myopia, and hyperopia. Adults (n = 46; mean age, 22.15 ± 3.00 years) with normal accommodation and a wide range of refractive errors (spherical equivalent refraction [SER]: -7.50 D to +7.88 D) were recruited. CASIA2 AS-OCT measured anterior segment changes during accommodation stimulated by the use of inbuilt accommodative targets and bespoke external stimuli at five different accommodative demands (0 D, 2 D, 3 D, 4 D, and 6 D) and under cycloplegia. Simultaneously, changes in refractive state were measured using the PowerRefractor3 photorefraction system. Lens thickness (LT), anterior chamber depth (ACD), lens diameter (LD), anterior segment length (ASL), anterior lens radius of curvature (ALRC), and posterior lens radius of curvature (PLRC) changed significantly during accommodation (all P < 0.001). Accommodative changes in LT, ACD, and ASL were significantly associated with the level of SER (all P < 0.05), as more hyperopic eyes showed significantly greater per-diopter change than myopic eyes in LT (P = 0.014) and ACD (P = 0.039) for comparatively similar accommodative response (P > 0.9). The analysis of lens position showed that cycloplegia induced posterior displacement of the lens. The CASIA2 internal accommodative target and the external proximal target induced similar structural and functional accommodative responses. There are significant differences between structural changes seen in accommodating eyes with different types and magnitudes of refractive error, with hyperopic eyes showing greater changes in LT and ACD than myopic eyes during accommodation.

AB - The impact of different refractive errors on accommodative structural changes remains unclear. Novel swept-source imaging technology in anterior segment optical coherence tomography (AS-OCT) has enabled in vivo investigation of the accommodating eye. This study investigated ocular structural change and corresponding functional responses during accommodation in individuals with emmetropia, myopia, and hyperopia. Adults (n = 46; mean age, 22.15 ± 3.00 years) with normal accommodation and a wide range of refractive errors (spherical equivalent refraction [SER]: -7.50 D to +7.88 D) were recruited. CASIA2 AS-OCT measured anterior segment changes during accommodation stimulated by the use of inbuilt accommodative targets and bespoke external stimuli at five different accommodative demands (0 D, 2 D, 3 D, 4 D, and 6 D) and under cycloplegia. Simultaneously, changes in refractive state were measured using the PowerRefractor3 photorefraction system. Lens thickness (LT), anterior chamber depth (ACD), lens diameter (LD), anterior segment length (ASL), anterior lens radius of curvature (ALRC), and posterior lens radius of curvature (PLRC) changed significantly during accommodation (all P < 0.001). Accommodative changes in LT, ACD, and ASL were significantly associated with the level of SER (all P < 0.05), as more hyperopic eyes showed significantly greater per-diopter change than myopic eyes in LT (P = 0.014) and ACD (P = 0.039) for comparatively similar accommodative response (P > 0.9). The analysis of lens position showed that cycloplegia induced posterior displacement of the lens. The CASIA2 internal accommodative target and the external proximal target induced similar structural and functional accommodative responses. There are significant differences between structural changes seen in accommodating eyes with different types and magnitudes of refractive error, with hyperopic eyes showing greater changes in LT and ACD than myopic eyes during accommodation.

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Hyperopic eyes are structurally more dynamic than myopic eyes during accommodation: an in-vivo investigation

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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Towards seeing clearly: the contribution of atypical optical structures to refractive error and accommodative function in Down syndrome

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Hyperopic eyes are structurally more dynamic than myopic eyes during accommodation: an in-vivo investigation

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Student theses

Towards seeing clearly: the contribution of atypical optical structures to refractive error and accommodative function in Down syndrome

Cite this