Name: Shumaila Azam

Reg no: 70098213

Subject:Maimoona Rehmat

Topic:Accomodation
Section: B
Accomodation :-
The ability of the eye to change its focus from distant to near objects
(and vice versa). This process is achieved by the lens changing its shape.
Accommodaton is the adjustment of the optcs of the eye to keep an
object in focus on the retna as its distance from the eye varies.
 Far point: Positon of an object when its image clearly falls on
retna with no accommodaton.
 Near point: Nearest point clearly seen with maximum
accommodaton.
 Range of accommodaton: Distance between far point and near
point.

 Amplitude of accommodaton: Dioptric power diference between

rest and fully accommodated eye.
 A=P-R (A: amplitude of accommodaton: P:dioptric
value of near point; and R: dioptric value of far
point.
 What happens to the near point of accommodation as a person
age?
•During near accommodaton, the lens equator moves outward causing
an increase in lens diameter.
•The near point of accommodaton gradually recedes from about 7 cm
at the age of 10 years to about 20 cm at the age of 40 years and it
recedes further to about 40 cm at about the age of 50 years.
 What causes near point of accommodation?
•In order to fxate on a near object, the ciliary muscle contracts around
the lens to decrease its size.
•The suspensory zonules of Zinn relax and the radial tension around the
lens is released.
•This causes the lens to form a more spherical shape achieving a higher
level of refractve power.
 How to check near point of accommodation?
• Near point of accommodaton Push Up Test”:

•For this test, use relatvely small leters (0.4M or 0.5M) to help beter
control accommodaton.
•Slowly move these leters closer to the eye untl they become blurry.
•Measure the distance the leters became blurry. This is the near point
of accommodaton.
 How do you calculate near point?
 Strategy:-The near point is 25 cm from the eye, so the object
distance is do=25 cm. We determine the image distance from the
lens equaton.
 Solution:-
di=(1f−1do) −1. =(11.7cm−125cm) −1.
 Signifcance:-
From the magnifcaton formula, we fnd m=−1.8cm25cm=−0.073.
 How is near point of accommodation afected by myopia?
• Because of myopia and hypermetropia image is not focused on
retna.
• In myopes image is focused in front of retna and hence near
point is more near to pt.
• While in hyperopes image focused behind retna, patent cannot
see near objects as near point further moves away from eye thus
decreasing amplitude of accommodaton.
• Eye and amplitude of accommodaton increases in uncorrected
myopes.
 Causes:-
 Decrease in accommodatve power of lens with increasing age,
leads to presbyopia, occurs due to:
 Age-related changes in lens:
 Decrease in elastcity of lens capsule, and
 Progressive, increase in size and hardness (sclerosis) of lens
substance which is not easily moulded.
 Age related decline in ciliary muscle power.
 Symptoms:-
 Difficulty in near vision.
 Patents complaint of difficulty in reading small prints •
Asthenopic symptoms due to fatgue of the ciliary muscle are also
 complained
 after reading or doing any near work.
 Optical treatment:-
 Prescripton of appropriate convex glasses for near work.
 A rough guide for providing presbyopic glasses in an emmetrope
can be made from patentts age.
 About +1 DS is required at the age of 40-45 years,
 +1.5 DS at 45-50 years,
 + 2 DS at 50-55 years,
 +2.5 DS at 55-60 years.
 Surgical Treatment
 Corneal procedures
 Non ablatve corneal procedure
 Monovision CK
 Laser based corneal procedure
 Laser thermal keratoplasty (LTK)
 Monovision LASIK.
 Presbyopic bifocal LASIK
 Presbyopic multfocal LASIK C
