'The role of accommodative function in myopic development: A review.'

Purpose: Involvement of the accommodative mechanism in myopia progression has been hypothesised and investigated over the past years, given the emerging myopia crisis across the globe. This review aimed at exploring the clinical role of accommodative function in myopia development.Methods: A literature search of MEDLINE and EMBASE was performed from conception to May 2021.Results:The initial stimulus for accommodation is derived from near work, in an attempt of the eye to obtain a clear image. When there is a lag in the accommodative response, the resulting blurred retinal image is believed to precipitate axial elongation and lead to myopia development. The dynamic accommodative functions implicated in binocular vision evaluation include the accommodative accuracy, amplitude and facility. Association of these accommodative parameters to current treatment options for myopia control is of great clinical interest. Effective myopia treatments, including orthokeratology, multifocal lenses and atropine eyedrops appear to induce changes in the dynamic accommodative response.Conclusions: Current knowledge indicates an evident relationship between the accommodative mechanism and myopia development. Further investigation by future studies is warranted in order to explore the use of accommodative function as a promising myopia-monitoring tool.