Flitcroft D I
Institute of Ophthalmology, University College Dublin, Ireland.
Vision Res. 1998 Oct;38(19):2869-79. doi: 10.1016/s0042-6989(98)00087-x.
The purpose of this work was to investigate quantitatively the interactions between accommodation, vergence and a mechanism of emmetropization driven by optical blur within the retinal image with a view to developing a model that provides an explanation of both normal emmetropization and near-work associated myopia. The simulations of the change in the refractive state of the eye over time that derive from this model indicate that optical regulation of eye growth can result in emmetropization, i.e. a progressive reduction in refractive errors over time leading towards emmetropia. This occurs when viewing conditions involve a preponderance of distance work. With increasing near work, the model predicts that the refraction of the eyes will converge towards myopia. In keeping with the previously reported associations of myopia with esophoria, poor accommodation function and high AC/A ratios, these conditions increase the amount of myopia produced under intensive near viewing conditions but do not lead to myopia during mainly distance viewing. This model provides quantitative validation of the hypothesis that the epidemiological association between myopia and increased nearwork may be caused by a disturbance of normal emmetropization by steady state errors of accommodation. The same model can explain normal emmetropization, increasing myopia with increasing nearwork demands and the currently recognised oculomotor associations that have been reported to precede the development of myopia.
这项工作的目的是定量研究调节、聚散以及视网膜图像中由光学模糊驱动的正视化机制之间的相互作用，以期建立一个模型，用以解释正常正视化和与近距工作相关的近视。从该模型得出的眼睛屈光状态随时间变化的模拟结果表明，眼睛生长的光学调节可导致正视化，即屈光不正随时间逐渐减少，最终趋向正视。当观看条件以远距离工作为主时会出现这种情况。随着近距工作的增加，该模型预测眼睛的屈光将趋向近视。与先前报道的近视与内隐斜、调节功能不良以及高AC/A比值之间的关联一致，这些情况会增加在高强度近距观看条件下产生的近视量，但在主要为远距离观看时不会导致近视。该模型为以下假设提供了定量验证：近视与增加的近距工作之间的流行病学关联可能是由调节的稳态误差对正常正视化的干扰所致。同一模型可以解释正常正视化、随着近距工作需求增加近视程度增加以及目前已被认可的、据报道在近视发展之前出现的眼动关联。
