Mechanism of accommodation assessed by change in precisely registered ocular images associated with concurrent change in auto-refraction

  • Andrzej Grzybowski
  • Ronald A. Schachar
  • Magdalena Gaca-Wysocka
  • Ira H. Schachar
  • Farhad Kamangar
  • Barbara K. Pierscionek



Our purpose was to determine the changes in anterior chamber depth (ACD) and central lens thickness (CLT) during pharmacologically induced accommodation.


Following pupillary dilation with phenylephrine 10%, baseline auto-refractions and swept-source optical coherence tomographic biometric images (Zeiss IOLMaster 700) were obtained from the right eyes of 25 subjects aged 19 to 24 years. Pilocarpine 4% and phenylephrine 10% were then instilled into these right eyes. One hour later, auto-refractions and biometric imaging were repeated. Only data from eight of 25 subjects met the following stringent criteria to be included in the study analysis: pre and post-pilocarpine biometric foveal images were registerable, the images of the corneal centers were shifted by ≤100 μm, pupils >5 mm and the pharmacologically induced refractive change was ≥ −7 diopters.


The mean auto-refractive accommodative change for the eight included subjects was −12.45 diopters (± 3.45 diopters). The mean change in CLT was 81 μm (± 54 μm) and the mean change in ACD was −145 μm (± 86 μm). Superimposition of the registered pre and post-pilocarpine biometric images of the sagittal sections of the whole eye from each subject demonstrated that the position of the whole lens did not shift either anteriorly, posteriorly or vertically during pharmacologically induced accommodation.


A small increase in lens thickness was associated with a large change in accommodative amplitude and no significant change in lens position as predicted by the Schachar theory.


Accommodation Central lens thickness Image registration Mechanism Small displacement 



No funding was received for this research.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Andrzej Grzybowski
    • 1
    • 2
  • Ronald A. Schachar
    • 3
  • Magdalena Gaca-Wysocka
    • 1
    • 2
  • Ira H. Schachar
    • 4
  • Farhad Kamangar
    • 5
  • Barbara K. Pierscionek
    • 6
  1. 1.Department of OphthalmologyCity HospitalPoznanPoland
  2. 2.Department of OphthalmologyUniversity of Warmia and MazuryOlsztynPoland
  3. 3.Department of PhysicsUniversity of Texas in ArlingtonArlingtonUSA
  4. 4.Byers Eye Institute, Horngren Family Vitreoretinal Center, Department of OphthalmologyStanford University School of MedicinePalo AltoUSA
  5. 5.Department of Computer Science and EngineeringUniversity of Texas in ArlingtonArlingtonUSA
  6. 6.School of Science and TechnologyNottingham Trent UniversityNottinghamUK

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