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Purpose: to evaluate near visual work performance of those wearing spectacles with Stellest™ lenses and the impact of their continuous wear on refraction changes, accommodation and binocular interaction after 6 months from the start of use. Material and methods. 35 children aged 8-13 with myopia of 3.15 ± 0.19 D were prescribed eyeglasses with Stellest™ lenses. 32 children with myopia of 2.68 ± 0.18 D who used monofocal glasses served as control. Visual performance, refraction, axial length (AL), accommodation and binocular interaction were assessed. Results. According to the Burdon test, the number of errors in counting letters in Stellest™ glasses was 4.5 ± 0.64, whilst in monofocal glasses it was- significantly less, 2.96 ± 0.42 (p < 0.05); the rate of test progress was the same in the two groups. After 6 months from the start of wearing Stellest™ glasses, the objective cycloplegic refraction increased by 0.11 ± 0.04 D, the average year progression rate (YPR) was 0.22 ± 0.08 D. In contrast, the children wearing monofocal glasses showed an average refraction increase of 0.35 ± 0.05 D, and the average YPR value of 0.7 ± 0.09 D. In the Stellest™group, YPG drop was observed in 87 % of cases and averaged 0.95 ± 0.11 D. In the control group, YPR was found to drop in 65 % of cases and averaged 0.49 ± 0.1 D. In the Stellest™ group, AL increased by 0.04 ± 0.02 mm; in the control group, the increase in AL was 2.8 times greater — by 0.11 ± 0.02 mm (p < 0.01). In the Stellest™ group, relative accommodation reserves (RAR) increased by 0.88 ± 0.14 D, which is significantly higher than in the group wearing monofocal glasses, where the increase was 0.39 ± 0.12 D (p < 0.01). No differences were revealed between the groups in objective indicators of accommodation and binocular interaction. Conclusion. Wearing spectacles with Stellest™ lenses for 6 months contributes to slowing down the progression of myopia in children. Over the observation period, the refraction increase in the main group was 3.2 times lower than in the control group, whilst AL growth was 2.8 times lower than that in the control group. The children using spectacles with Stellest™ lenses showed a higher increase in RAR as compared to children wearing monofocal spectacles. The accommodation tone and objective accommodation parameters were essentially the same in both groups. Wearing Stellest™ glasses had no pronounced effect on binocular interaction.

Purpose. This paper presents the results of objective accommodation measurements taken from patients with concomitant strabismus. Materials and methods. The experiment was performed on 32 patients (64 eyes) ranging from 5-26 years of age (in average 13.5 ± 1.43 years old): 26 patients with esotropia (52 eyes), 2 patients with exotropia (4 eyes), and 4 patients with secondary strabismus (8 eyes). 8 of the patients (10 eyes) identified amblyopia of various degrees. 51 of the eyes exhibited hyperopia from 0.5 to 9.5 D according to spherical equivalent refraction, and 16 eyes exhibited myopia from 0.25 to 10 D. The control group consisted of 30 children with hyperopia (16 eyes), emmetropia (10 eyes), and myopia of various degrees (34 eyes) without strabismus. To determine specific indicators of objective accommodation - Binocular (BAR) and Monocular Accommodative Response (MAR), the options of consensual accommodation, as well as the resting state of accommodation (RSA) in concomitant strabismus - the open field autorefkeratometer Grand Seiko WR - 5100K was used. The degree of deviation was determined using the Hirschberg test and a handheld ophthalmoscope. Results. The MAR ranged between normal and drastically lower values averaging at -1.85 ± 0.1 D. The BAR averaged at 2.23 ± 0.1 D and was greater than the MAR in half of the measured cases (61.3 %). The interocular difference in the BAR reached 2.95 D, averaging at 0.87±0.14 D. The interocular difference in MAR reached 0.85 D, averaging at 0.34 ± 0.07 D. In the control group, BAR values were lower than MAR; the interocular differences consisted of 0.13 ± 0.01 and 0.08 ± 0.01 D, respectively. Highly amblyopic eyes had equal and drastically decreased BAR and MAR (average of -0.16 ± 0.07 D); in the fellow eyes, BAR and MAR were higher -1.08 ± 0.14 and -1.0 ± 0.14 D, respectively. In esotropic eyes, RSA was higher in the misaligned eye, and in exotropic eyes, RSA was lower in the misaligned eye. The straight and concomitant responses were decreased: until -1.43 ± 0.1 and -1.32 ± 0.15 D respectively. In the control group, the straight and concomitant accommodative response was similar (average of -1.77 ± 0.17 D in both cases). Conclusion. The results showed the characteristic changes in accommodative parameters as a result of heterotropia, not typical for orthotropic patients with various types of refraction // Russian Ophthalmological Journal, 2017; 1: 49-54. doi: 10.21516/2072-0076-2017-10-1-49-54.

Purpose: To develop an objective method of determining binocular accommodative response (AR) and concomitant accommodation in patients with strabismus., Material and Methods: The study included 34 patients (68 eyes) with concomitant horizontal strabismus aged 6 to 32 years. The parameters of accommodation were measured using open field Binocular Auto Ref/Keratometer Grand Seiko WR-5100K (Grand Seiko Co. Ltd., Japan). The prism was placed in front of the deviated eye or the prisms were distributed evenly in front of both eyes until the deviation was eliminated., Results: The addition of prisms had no effect on the refractometry results. In convergent strabismus monocular, binocular, direct and consensual accommodation responses were significantly higher than in divergent: -2.15±0.1 D and -1.66±0.12 D; -2.13±0.09 D and -1.33±0.14 D; -2,04±0,15 D and -1,16±0,1 D; -1.97±0.15 D and -1.06±0.09 D, respectively. In divergent strabismus and myopia, the binocular response was 2.8 times higher than in hyperopia (-1.8±0.09 D and -0.63±0.04 D, respectively). Resting tonus of accommodation (RTA) value was higher in patients with hyperopia, both with convergent (mean -2.27±0.41 D) and divergent strabismus (-2.36±0.47 D). Minimal RTA was observed in patients with convergent strabismus and myopia (mean -0.75±0.1 D)., Conclusion: The study resulted in the development of a method of objective accommodometry of strabismic patients with deviation eliminated by prisms. Monocular and binocular AR were significantly higher in convergent strabismus compared to divergent, where consensual accommodation of the squinting eye is significantly reduced compared to the paired one. In patients with consensual strabismus, RTA is significantly higher in hyperopia than in myopia regardless of the form of strabismus.

Purpose: To compare the wavefront and accommodation parameters without correction and in soft contact lenses (SCL) in natural and cycloplegic conditions in eyes with myopia and hyperopia., Material and Methods: A total of 142 myopic (mean -5.6±1.4 D) and 48 hyperopic (mean +3.5±1.1 D) eyes were examined in 95 patients aged 5-32 years (mean age 16.9±0.9 years) to compare the wavefront aberrations without correction and with different SCL before and after cycloplegia (two drops of cyclopentolate hydrochloride 1%). The device was set up for 4 mm zone for both narrow and wide pupils. To compare the accommodation parameters under different correction conditions, 85 patients aged 8-23 years (mean age 14.9±0.6 years) with average myopia of (-)5.27±1.4D (123 eyes) and average hyperopia of +3.53±1.2 D (46 eyes) were chosen from the study group. Among the measured parameters are objective accommodative response (OAR), relative accommodation reserves (RAR), pseudoaccumulation amplitude (PA), higher-order aberrations: RMSHOAs, 6-9 Trefoil, 7-8 Coma, spherical aberration (SA)., Results: In myopic eyes with SCL Coma 7 decreases, Coma 8 increases with transition to positive values, and Trefoil 9 increases. In hyperopic eyes, trefoil 6 decreases, Coma 7-8 go negative. In myopic or hyperopic eyes with SCL, SA goes from positive to negative. In both myopia and hyperopia, accommodation and PA rates are higher in SCL than in glasses., Conclusion: SCL change certain wavefront parameters for myopia and hyperopia in different ways. The accommodation parameters in SCL are elevated in both myopia and hyperopia. The negative spherical aberration induced by contact lenses improves the accommodative response. The revealed features should be considered in the development of correction methods that target refractogenesis.

Aim: To study the magnitude of objective accommodative response (OAR) with account to the method of image defocusing. The latter can be realized by bringing the object nearer to the eye or by adding a minus lens in front of the viewer., Material and Methods: We examined 63 patients (126 eyes) with different refraction aged from 7 to 31 years. All patients underwent a series of OAR measurements on WR-5100K Grand Seiko Binocular Open-Field Autorefkeratometer under different conditions, including negative spherical lenses of -3.0 D and -5.0 D, test optotypes corresponding to visual acuity of 0.2 and 0.7 and presented at a distance of 5 m, and a set of variably sized optotypes presented at a distance of 33 cm and 20 cm., Results: A disparity was found between the magnitude of accommodative responses evoked through different means: placing a negative lens in front of the viewer while he/she looks into the distance or bringing the object closer to the eye. In almost all cases lens-induced responses were less pronounced than distance-induced. In all myopic children, accommodative lag was longer at near than at distance. Generally, in all groups, OAR to distant objects as well as responses to a 3.0 D accommodative task at near did not depend on the size of the object. There was an insignificant and statistically unreliable difference for objects placed 20 cm away (5.0 D accommodative task): OAR to a smaller font was stronger than that to a larger one., Conclusion: In children and adults with emmetropia, hyperopic children, and myopic adults, longer accommodative lags were characteristic of lens-induced responses. In children with myopia, longer lags were observed at near. Moreover, at near, OAR to a smaller font was stronger than that to a larger one.