Tonic accommodation: a review. II. Accommodative adaptation and clinical aspects

Mark Rosenfield, Kenneth J. Ciuffreda, George K. Hung, Bernard Gilmartin

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations


Part I of this review considered basic aspects of tonic accommodation (TA). i.e. the accommodative response observed under degraded stimulus conditions. Part II considers accommodative adaptation, i.e. the apparent change in TA following periods of sustained fixation, and clinical aspects of both baseline TA and accommodative adaptation. It is suggested that the apparent post‐task shift in TA reflects the slow rate of decay of the stimulus‐mediated adaptive accommodative response, while the actual level of tonic innervation to the ciliary muscle remains relatively constant. The clinical implications of both TA and accommodative adaptation are discussed with regard to night, space and instrument myopia and refractive error development, notably nearwork‐induced myopia. It is concluded that the evidence for any association between this form of myopia and either TA or accommodative adaptation is equivocal, and furthermore it seems likely that TA plays only a minor role in influencing the closed‐loop steady‐state accommodative response.

Original languageEnglish (US)
Pages (from-to)265-277
Number of pages13
JournalOphthalmic and Physiological Optics
Issue number3
StatePublished - Jul 1994

All Science Journal Classification (ASJC) codes

  • Sensory Systems
  • Ophthalmology
  • Optometry


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