Accommodative lag and fluctuations when optical aberrations are manipulated.

We evaluated the accommodative response to a stimulus moving from 0 to 6 D following a staircase function under natural, corrected, and induced optical aberrations, using an adaptive-optics (AO) electromagnetic deformable mirror. The accommodative response of the eye (through the mirror) and the change of aberrations were measured on 5 subjects using a Hartmann-Shack wavefront sensor operating at 12.8 Hz. Five conditions were tested: (1) natural aberrations, (2) AO correction of the unaccommodated state and induction (over 6-mm pupils) of (3) +1 microm and (4) -1 microm of spherical aberration and (5) -2 microm of vertical coma. Four subjects showed a better accommodative response with AO correction than with their natural aberrations. The induction of negative spherical aberration also produced a better accommodative response in the same subjects. Accommodative lag increased in all subjects when positive spherical aberration and coma were induced. Fluctuations of the accommodative response (computed during each 1-D period of steady accommodation) increased with accommodative response when high-order aberrations were induced. The largest fluctuations occurred for induced negative spherical aberration and the smallest for natural and corrected aberrations. The study demonstrates that aberrations influence accommodative lag and fluctuations of accommodation and that correcting aberrations improves rather than compromises the accommodative response.