Accommodative Exercises to Lower Intraocular Pressure

Purpose. This study investigated how a conscious change in ocular accommodation affects intraocular pressure (IOP) and ocular biometrics in healthy adult volunteers of different ages. Methods. Thirty-five healthy volunteers without ocular disease or past ocular surgery, and with refractive error bet...

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Main Authors: Thomas J. Stokkermans, Jeremy C. Reitinger, George Tye, Chiu-Yen Kao, Sangeetha Ragupathy, Huachun A. Wang, Carol B. Toris
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2020/6613066
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author Thomas J. Stokkermans
Jeremy C. Reitinger
George Tye
Chiu-Yen Kao
Sangeetha Ragupathy
Huachun A. Wang
Carol B. Toris
author_facet Thomas J. Stokkermans
Jeremy C. Reitinger
George Tye
Chiu-Yen Kao
Sangeetha Ragupathy
Huachun A. Wang
Carol B. Toris
author_sort Thomas J. Stokkermans
collection DOAJ
description Purpose. This study investigated how a conscious change in ocular accommodation affects intraocular pressure (IOP) and ocular biometrics in healthy adult volunteers of different ages. Methods. Thirty-five healthy volunteers without ocular disease or past ocular surgery, and with refractive error between −3.50 and +2.50 diopters, were stratified into 20, 40, and 60 year old (y.o.) age groups. Baseline measurements of central cornea thickness, anterior chamber depth, anterior chamber angle, cornea diameter, pupil size, and ciliary muscle thickness were made by autorefraction and optical coherence tomography (OCT), while IOP was measured by pneumotonometry. Each subject’s right eye focused on a target 40 cm away. Three different tests were performed in random order: (1) 10 minutes of nonaccommodation (gazing at the target through lenses that allowed clear vision without accommodating), (2) 10 minutes of accommodation (addition of a minus 3 diopter lens), and (3) 10 minutes of alternating between accommodation and nonaccommodation (1-minute intervals). IOP was measured immediately after each test. A 20-minute rest period was provided between tests. Data from 31 subjects were included in the study. ANOVA and paired t-tests were used for statistical analyses. Results. Following alternating accommodation, IOP decreased by 0.7 mmHg in the right eye when all age groups were combined (p = 0.029). Accommodation or nonaccommodation alone did not decrease IOP. Compared to the 20 y.o. group, the 60 y.o. group had a thicker ciliary muscle within 75 μm of the scleral spur, a thinner ciliary muscle at 125–300 μm from the scleral spur, narrower anterior chamber angles, shallower anterior chambers, and smaller pupils during accommodation and nonaccommodation (p’s < 0.01). Conclusion. Alternating accommodation, but not constant accommodation, significantly decreased IOP. This effect was not lost with aging despite physical changes to the aging eye. A greater accommodative workload and/or longer test period may improve the effect.
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spelling doaj-art-f76c1746d5c14a0faa33843daa0daaf92025-02-03T05:58:27ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/66130666613066Accommodative Exercises to Lower Intraocular PressureThomas J. Stokkermans0Jeremy C. Reitinger1George Tye2Chiu-Yen Kao3Sangeetha Ragupathy4Huachun A. Wang5Carol B. Toris6University Hospitals Cleveland Medical Center, Cleveland, Ohio, USACreighton University School of Medicine, Omaha, Nebraska, USACase Western Reserve University, Cleveland, Ohio, USAClaremont McKenna College, Claremont, California, USACase Western Reserve University, Cleveland, Ohio, USAUniversity of Nebraska Medical Center, Omaha, Nebraska, USACase Western Reserve University, Cleveland, Ohio, USAPurpose. This study investigated how a conscious change in ocular accommodation affects intraocular pressure (IOP) and ocular biometrics in healthy adult volunteers of different ages. Methods. Thirty-five healthy volunteers without ocular disease or past ocular surgery, and with refractive error between −3.50 and +2.50 diopters, were stratified into 20, 40, and 60 year old (y.o.) age groups. Baseline measurements of central cornea thickness, anterior chamber depth, anterior chamber angle, cornea diameter, pupil size, and ciliary muscle thickness were made by autorefraction and optical coherence tomography (OCT), while IOP was measured by pneumotonometry. Each subject’s right eye focused on a target 40 cm away. Three different tests were performed in random order: (1) 10 minutes of nonaccommodation (gazing at the target through lenses that allowed clear vision without accommodating), (2) 10 minutes of accommodation (addition of a minus 3 diopter lens), and (3) 10 minutes of alternating between accommodation and nonaccommodation (1-minute intervals). IOP was measured immediately after each test. A 20-minute rest period was provided between tests. Data from 31 subjects were included in the study. ANOVA and paired t-tests were used for statistical analyses. Results. Following alternating accommodation, IOP decreased by 0.7 mmHg in the right eye when all age groups were combined (p = 0.029). Accommodation or nonaccommodation alone did not decrease IOP. Compared to the 20 y.o. group, the 60 y.o. group had a thicker ciliary muscle within 75 μm of the scleral spur, a thinner ciliary muscle at 125–300 μm from the scleral spur, narrower anterior chamber angles, shallower anterior chambers, and smaller pupils during accommodation and nonaccommodation (p’s < 0.01). Conclusion. Alternating accommodation, but not constant accommodation, significantly decreased IOP. This effect was not lost with aging despite physical changes to the aging eye. A greater accommodative workload and/or longer test period may improve the effect.http://dx.doi.org/10.1155/2020/6613066
spellingShingle Thomas J. Stokkermans
Jeremy C. Reitinger
George Tye
Chiu-Yen Kao
Sangeetha Ragupathy
Huachun A. Wang
Carol B. Toris
Accommodative Exercises to Lower Intraocular Pressure
Journal of Ophthalmology
title Accommodative Exercises to Lower Intraocular Pressure
title_full Accommodative Exercises to Lower Intraocular Pressure
title_fullStr Accommodative Exercises to Lower Intraocular Pressure
title_full_unstemmed Accommodative Exercises to Lower Intraocular Pressure
title_short Accommodative Exercises to Lower Intraocular Pressure
title_sort accommodative exercises to lower intraocular pressure
url http://dx.doi.org/10.1155/2020/6613066
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