Negative relative accommodation

Last updated

Negative relative accommodation (NRA) was proposed[ clarification needed ] by Joseph Kearney of Oxford University in 1967 as a measure of the maximum ability to relax accommodation while maintaining clear, single binocular vision. This measurement is typically obtained by an orthoptist, ophthalmologist or optometrist during an eye examination using a phoropter. After the patient's distance correction is established, the patient is instructed to view small letters on a card 40 cm from the eyes. The examiner adds lenses in +0.25 increments until the patient first reports that they become blurry. The total value of the lenses added to reach this point is the NRA value. High NRA values (above +2.50) might be evidence to over minus, uncorrected hyperopia or latent hyperopia.

See also

Related Research Articles

<span class="mw-page-title-main">Dioptre</span> Unit of measurement of optical power

A dioptre or diopter is a unit of measurement with dimension of reciprocal length, equivalent to one reciprocal metre, 1 dioptre = 1 m−1. It is normally used to express the optical power of a lens or curved mirror, which is a physical quantity equal to the reciprocal of the focal length, expressed in metres. For example, a 3-dioptre lens brings parallel rays of light to focus at 13 metre. A flat window has an optical power of zero dioptres, as it does not cause light to converge or diverge. Dioptres are also sometimes used for other reciprocals of distance, particularly radii of curvature and the vergence of optical beams.

<span class="mw-page-title-main">Esotropia</span> Form of strabismus

Esotropia is a form of strabismus in which one or both eyes turns inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. It is the opposite of exotropia and usually involves more severe axis deviation than esophoria. Esotropia is sometimes erroneously called "lazy eye", which describes the condition of amblyopia; a reduction in vision of one or both eyes that is not the result of any pathology of the eye and cannot be resolved by the use of corrective lenses. Amblyopia can, however, arise as a result of esotropia occurring in childhood: In order to relieve symptoms of diplopia or double vision, the child's brain will ignore or "suppress" the image from the esotropic eye, which when allowed to continue untreated will lead to the development of amblyopia. Treatment options for esotropia include glasses to correct refractive errors, the use of prisms and/or orthoptic exercises and/or eye muscle surgery. The term is from Greek eso meaning "inward" and trope meaning "a turning".

<span class="mw-page-title-main">Far-sightedness</span> Eye condition in which light is focused behind instead of on the retina

Far-sightedness, also known as long-sightedness, hypermetropia, or hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blurred effect is due to incoming light being focused behind, instead of on, the retina wall due to insufficient accommodation by the lens. Minor hypermetropia in young patients is usually corrected by their accommodation, without any defects in vision. But, due to this accommodative effort for distant vision, people may complain of eye strain during prolonged reading. Some hypermetropes can see clear at distance, but near vision may be blurred due to insufficient accommodation. For this reason, this defect is referred as far-sightedness. If the hypermetropia is high, there will be defective vision for both distance and near. People may also experience accommodative dysfunction, binocular dysfunction, amblyopia, and strabismus. Newborns are almost invariably hypermetropic, but it gradually decreases as the newborn gets older.

<span class="mw-page-title-main">Eyeglass prescription</span> Order written by an eyewear prescriber

An eyeglass prescription is an order written by an eyewear prescriber, such as an optometrist, that specifies the value of all parameters the prescriber has deemed necessary to construct and/or dispense corrective lenses appropriate for a patient. If an eye examination indicates that corrective lenses are appropriate, the prescriber generally provides the patient with an eyewear prescription at the conclusion of the exam.

<span class="mw-page-title-main">Progressive lens</span>

Progressive lenses, also called multifocal lenses, progressive addition lenses (PAL), varifocal lenses, progressive power lenses, graduated prescription lenses, or progressive spectacle lenses are corrective lenses used in eyeglasses to correct presbyopia and other disorders of accommodation. They are characterised by a gradient of increasing lens power, added to the wearer's correction for the other refractive errors. The gradient starts at the wearer's distance prescription at the top of the lens and reaches a maximum addition power, or the full reading addition, at the bottom of the lens. The length of the progressive power gradient on the lens surface depends on the design of the lens, with a final addition power between 0.75 and 3.50 dioptres. The addition value prescribed depends on the level of presbyopia of the patient. In general the older the patient, the higher the addition.

<span class="mw-page-title-main">Refractive error</span> Problem with focusing light accurately on the retina due to the shape of the eye

Refractive error, also known as refraction error, is a problem with focusing light accurately on the retina due to the shape of the eye and or cornea. The most common types of refractive error are near-sightedness, far-sightedness, astigmatism, and presbyopia. Near-sightedness results in far away objects being blurry, far-sightedness and presbyopia result in close objects being blurry, and astigmatism causes objects to appear stretched out or blurry. Other symptoms may include double vision, headaches, and eye strain.

<span class="mw-page-title-main">Phakic intraocular lens</span> Lens implanted in eye in addition to the natural lens

A phakic intraocular lens (PIOL) is a special kind of intraocular lens that is implanted surgically into the eye to correct myopia (nearsightedness). It is called "phakic" because the eye's natural lens is left untouched. Intraocular lenses that are implanted into eyes after the eye's natural lens has been removed during cataract surgery are known as pseudophakic.

Orthokeratology, also referred to as Night lenses, Ortho-K, OK, Overnight Vision Correction, Corneal Refractive Therapy (CRT), Accelerated Orthokeretology, Cornea Corrective Contacts, Eccentricity Zero Molding, and Gentle Vision Shaping System (GVSS), is the use of gas-permeable contact lenses that temporarily reshape the cornea to reduce refractive errors such as myopia, hyperopia, and astigmatism.

<span class="mw-page-title-main">Eye examination</span> Series of tests assessing vision and pertaining to the eyes

An eye examination is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations pertaining to the eyes. Eye examinations are primarily performed by an optometrist, ophthalmologist, or an orthoptist. Health care professionals often recommend that all people should have periodic and thorough eye examinations as part of routine primary care, especially since many eye diseases are asymptomatic.

<span class="mw-page-title-main">Accommodation (vertebrate eye)</span> Focusing ability of eye

Accommodation is the process by which the vertebrate eye changes optical power to maintain a clear image or focus on an object as its distance varies. In this, distances vary for individuals from the far point—the maximum distance from the eye for which a clear image of an object can be seen, to the near point—the minimum distance for a clear image. Accommodation usually acts like a reflex, including part of the accommodation-vergence reflex, but it can also be consciously controlled. Mammals, birds and reptiles vary their eyes' optical power by changing the form of the elastic lens using the ciliary body. Fish and amphibians vary the power by changing the distance between a rigid lens and the retina with muscles.

Aphakia is the absence of the lens of the eye, due to surgical removal, such as in cataract surgery, a perforating wound or ulcer, or congenital anomaly. It causes a loss of ability to maintain focus (accommodation), high degree of farsightedness (hyperopia), and a deep anterior chamber. Complications include detachment of the vitreous or retina, and glaucoma.

<span class="mw-page-title-main">Retinoscopy</span> Technique to measure refractive error in eyes

Retinoscopy (Ret) is a technique to obtain an objective measurement of the refractive error of a patient's eyes. The examiner uses a retinoscope to shine light into the patient's eye and observes the reflection (reflex) off the patient's retina. While moving the streak or spot of light across the pupil the examiner observes the relative movement of the reflex or manually places lenses over the eye to "neutralize" the reflex.

Positive relative accommodation (PRA) in biology, is a measure of the maximum ability to stimulate eye accommodation while maintaining clear, single binocular vision. This measurement is typically obtained by an orthoptist, ophthalmologist or optometrist during an eye examination using a phoropter. After the patient's distance correction is established, she or he is instructed to view small letters on a card 40 cm from the eyes. The examiner adds lenses in −0.25 diopter increments until the patient first reports that they become blurry. The total value of the lenses added to reach this point is the PRA value.

Accommodative convergence is that portion of the range of inward rotation of both eyes that occurs in response to an increase in optical power for focusing by the crystalline lens. When the human eye engages the accommodation system to focus on a near object, signal is automatically sent to the extraocular muscles that are responsible for turning their eyes inward. This is helpful for maintaining single, clear, and comfortable vision during reading or similar near tasks. However, errors in this relationship can cause problems, such as hyperopic individuals having a tendency for crossed eyes because of the over exertion of their accommodation system.

In visual perception, the near point is the closest point at which an object can be placed and still form a focused image on the retina, within the eye's accommodation range. The other limit to the eye's accommodation range is the far point.

<span class="mw-page-title-main">Emmetropia</span> State of vision

Emmetropia is the state of vision in which a faraway object at infinity is in sharp focus with the ciliary muscle in a relaxed state. That condition of the normal eye is achieved when the refractive power of the cornea and eye lens and the axial length of the eye balance out, which focuses rays exactly on the retina, resulting in perfectly sharp distance vision. A human eye in a state of emmetropia requires no corrective lenses for distance; the vision scores well on a visual acuity test.

A spasm of accommodation is a condition in which the ciliary muscle of the eye remains in a constant state of contraction. Normal accommodation allows the eye to "accommodate" for near-vision. However, in a state of perpetual contraction, the ciliary muscle cannot relax when viewing distant objects. This causes vision to blur when attempting to view objects from a distance. This may cause pseudomyopia or latent hyperopia.

Vision of humans and other organisms depends on several organs such as the lens of the eye, and any vision correcting devices, which use optics to focus the image.

Laser blended vision is a sophisticated laser eye treatment which is used to treat presbyopia or other age-related eye conditions. It can be used to help people that simply need reading glasses, and also those who have started to need bifocal or varifocal spectacle correction due to ageing changes in the eye. It can be used for people who are also short-sighted (myopia) or long-sighted (hyperopia) and who also may have astigmatism.

The eye, like any other optical system, suffers from a number of specific optical aberrations. The optical quality of the eye is limited by optical aberrations, diffraction and scatter. Correction of spherocylindrical refractive errors has been possible for nearly two centuries following Airy's development of methods to measure and correct ocular astigmatism. It has only recently become possible to measure the aberrations of the eye and with the advent of refractive surgery it might be possible to correct certain types of irregular astigmatism.

References