The relationship between tonic accommodation and refractive error.

It is now well established that accommodation adopts an intermediate resting position in the absence of visual stimulation. It also has been shown that this tonic position of accommodation exhibits considerable variation among individuals (ie, 0-4 D). Previous studies have been somewhat inconclusive as to whether these individual differences in tonic accommodation are related to the refractive properties of the eye. This study investigates the relationship between tonic accommodation and refractive error with particular reference to both the value and the time course of tonic accommodation. Sixty-two subjects were used for the study, with an age range of 19-25 yr. Subjects were placed into one of four refractive groups, after considering factors pertaining to the theories of refractive development. Darkroom measures of tonic accommodation were determined using the infrared objective autorefractor, Canon Autoref R-1. Significant differences were found among the four refractive groups, with corrected hyperopes having the highest dioptric value of tonic accommodation and corrected late-onset myopes having the lowest dioptric value. The significant difference found between early- and late-onset myopes is suggested as a possible reason for the inconclusive results of some previous studies. It also was found that the time taken to reach a stable tonic position of accommodation was much slower for the hyperopic group than for the other refractive groups. The results are discussed in the light of recent findings on accommodative hysteresis and with respect to a dual innervation to the ciliary muscle.