Fatigue reduces tonic accommodation

Summary Ocular accommodation adopts a mean baseline response level of approximately 1.0 D in the absence of blur feedback (open‐loop state). This baseline or tonic accommodation (TA) can be elevated following a sustained monocular accommodative response to a dioptric stimulus (lens adaptation) that exceeds the baseline open‐loop level of TA. The accommodative response to the lens persists in the open‐loop state (accommodative hysteresis), and eventually decays to a stable end‐point. Interestingly, if the baseline TA is high, the monocularly adapted accommodative state can decay to an end‐point that is below the initial pre‐adapted baseline level of the TA (counter‐adaptive response) (McBrien, N.A. and Millodot, M., (1988). Differences in adaptation of TA with refractive state. Invest. Ophthalmol. Vis. Sci. , 29 , 460–469). We have investigated the possible contribution of accommodation fatigue to the counter‐adaptive change in baseline TA following sustained accommodation. Two fatigue procedures were used while viewing a target at 66 or 33 cm. In a monocular condition, accommodation was stimulated for 3 min with lens values alternating from −1.5 to +1.5 D at a rate of 0.25 Hz. In the binocular condition, convergence was stimulated with alternating prism values from 9 prism diopters (PD) base‐out to 9 PD base‐in. Both monocular and binocular tasks resulted in a significant reduction of TA. These results suggest that previously reported reductions of baseline TA following sustained monocular accommodation or binocular convergence could have resulted from fatigue of the accommodative system. Accommodative fatigue could be responsible for the lower values of TA observed in counter‐adaptive responses to sustained accommodative or convergence effort.