A posição de repouso do sistema acomodativo. Implicações clínicas

Cruz, Antônio Augusto Velasco e

doi:10.5935/0004-2749.19930036

RESUMO

Segundo a clássica teoria de Helmholtz, a posição de repouso do sistema acomodativo é o infinito. Esse modelo não é mais válido, visto que para a maioria das pessoas a posição de repouso do sistema é intermediária. O presente trabalho discute algumas implicações clínicas dessa nova abordagem, especialmente uma possível relação entre acomodação tônica e deterioração das esotropias acomodativas.

Palavras-chave:
acomodação; esotropia acomodativa; posição de repouso

SUMMARY

According to the classic theory of Helmholtz the accommodative system rests at optical infinity. However this assumption is no longer acceptable. In facty, it has been shown that for most subjects the accommodative system adopts an intermediate position of rest. The present paper discuss a possible relationship between tonic accommodation and the deterioration of accommodative esotropia.

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
Von Helmholtz, H. Helmholtz's treatise on physiological optics, 3rd ed. New York: Dover, Vol. 1, 1962.
²
Owens, D.A. The resting state of the eyes. Am. Scientist 72; 378-87, 1984.
³
Leibowitz, H.W. & Owens, D.A. Newevidence for the intermediate position of relaxed accommodation. Doc. Ophthalmol. 46: 133-47, 1978.
⁴
Bullimore, M.A. & Gilmartin, B. Tonic accommodation, cognitive demand, and ciliary muscle innervation. Am. J. Optom. Physiol. Opt 64: 45-50,1987.
⁵
Bullimore, M.A. & Gilmartin, B The measurement of adaptation of tonic accommodation under two open-loop conditions. Ophthalmic Physiol. Opt. 9: 72-5,1989.
⁶
Bullimore, M.A.; Gilmartin, B.; Hogan, R.E. Objective and subjective measurement of tonic accommodation. Ophthalmic Physiol. Opt. 6: 57-62,1986.
⁷
Ebenholtz, S.M. Long-term enduranceof adaptative shifts in tonic accommodation. Ophthalmic Physiol. Opt. 8; 427-31,1988.
⁸
Fisher, S.K.; Ciuffreda, KJ.; Levine, S. Tonic accommodation, accommodative hysteresis, and refractive error. Am J. Optom. Physiol. Opt. 64: 799-809,1987.
⁹
Gilmartin, B. & Hogan, R The relationship between tonic accommodation and ciliary muscle innervation. Invest. Ophthalmol. Vis. Sci. 26: 1024-8, 1985.
¹⁰
Gilmartin, B.; Hogan, R.E.; Thompson, S.M. The effect of timolol maleate on tonic accommodation, tonic vergence, and pupildiameter. Invest. Ophthalmol. Vis. Sci. 25: 763-70, 1984.
¹¹
Heath, G.G. Components of accommodation. Am. J. Optom. Arch. Am. Acad. Optom. 33: 569-79, 1956.
¹²
Mcbrien, N.A. & Millodot, M. The relationship between tonic accommodation and refractive error. Invest. Ophthalmol. Vis. Sci. 28:997-1004, 1987.
¹³
Rosenfeld, M. Evaluation of clinical techniques to measure tonicaccommodation. Optom Vis. Sci. 66: 809-14,1989.
¹⁴
Rosner, J. & Rosner, J. Relation between clinically measured tonic accommodationand refractive status in 6- to 14- year-old children. Optom. Vis. Sci. 66: 436-9, 1989.
¹⁵
Leibowitz, H.W. & Owens, D.A. Anomalous myopias and the intermediated dark focus of accommodation. Science 189: 646-8,1975.
¹⁶
Gilmartin, B. A review of the role of sympathetic innervation of the ciliary muscle in ocularaccommodation. Clin. Vision Sci. 6: 23-37, 1986.
¹⁷
De Valois, R & De Valois, K. Spatial Vision, 1 st ed. Oxford: University Press, 1990.
¹⁸
Westheimer, G. Pupil size and visual resolution. Vision Res. 4: 39-45, 1964.
¹⁹
Charman, W.N. & Tucker, J. Dependence of accommodation response on the spatial frequency spectrum of the observed object. Vision Res. 17: 129-39, 1977.
²⁰
Cruz, A.A.V.; Tanaka, E.; Held, R Is tonic accommodation involved in the deterioration of accommodative esodeviations? J. Ped. Ophthalmol. Strab., 1992 (Submitted to publication).
²¹
Ward, P.a. & Channan, W.N. An objective assessement of the effect of fogging onaccommodation Am J. Optom. Physiol. Opt 64: 762-7,1987.
²²
Gilmartin, B. & Bullimore, M.A. Sustained nearvision augments inhibitory sympathetic innervation of the ciliary muscle. Clin. Vision Sci. 1: 197-208, 1987.
²³
Mcbrien, N.A. & Millodot, M. Differences in adaptation of tonic accommodation with refractive state. Invest. Ophthalmol. Vis. Sci. 29: 460-9, 1988.
²⁴
Jampolsky, A. A simplified approach to strabismus diagnosis. In: Symposium on strabismus, Transactions of the New Orleans Academy of Medicine. Saint Louis: Mosby, 1971, p. 35.
²⁵
Raab, E.L. Deterioration in accommodative esotropia. In: Strabismus II, edited by Reinecke RD. Orlando: Grune and Stratton, 1984, p. 213-222.
²⁶
Baker, J.D. &Parks, M.M. Early-onsetaccommodative esotropia. Am. J. Ophthalmol. 90: 11-8, 1980.
²⁷
Raab, E.L. Etiologicfactors in accommodative esodeviation. Tr. Am. Ophth. Soc. 80: 656-94, 1982.
²⁸
Von Noorden, G.K. Binocular vision and Ocular motility. Theory and management of strabismus, 4th ed. Saint Louis: Mosby, 1990.
²⁹
Parks, M.M. & Wheller, M.B. Concomitantesodeviations. In: Clinical Ophthalmology, edited by Duante T. D. Pennsylvania: Lippincott, vol. 1, 1988, p. 3.
³⁰
Dickey, C.F. & Scott, W.E. The deterioration of accommodative esotropia: frequency, characteristics, and predictive factors. J. Ped. Ophthalmol. Strab. 25: 172-4, 1988.
³¹
Ludwig, I.H.; Parks, M.M.; Getson, P.R.; Kammerman, L.A. Rate of deterioration in accommodative esotropia correlated to the AC/A relationship. J. Ped. Ophthalmol. Strab. 25: 8-12, 1988.

Datas de Publicação

Publicação nesta coleção
Jun 1993

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
Von Helmholtz, H. Helmholtz's treatise on physiological optics, 3rd ed. New York: Dover, Vol. 1, 1962.

[2] ²
Owens, D.A. The resting state of the eyes. Am. Scientist 72; 378-87, 1984.

[3] ³
Leibowitz, H.W. & Owens, D.A. Newevidence for the intermediate position of relaxed accommodation. Doc. Ophthalmol. 46: 133-47, 1978.

[4] ⁴
Bullimore, M.A. & Gilmartin, B. Tonic accommodation, cognitive demand, and ciliary muscle innervation. Am. J. Optom. Physiol. Opt 64: 45-50,1987.

[5] ⁵
Bullimore, M.A. & Gilmartin, B The measurement of adaptation of tonic accommodation under two open-loop conditions. Ophthalmic Physiol. Opt. 9: 72-5,1989.

[6] ⁶
Bullimore, M.A.; Gilmartin, B.; Hogan, R.E. Objective and subjective measurement of tonic accommodation. Ophthalmic Physiol. Opt. 6: 57-62,1986.

[7] ⁷
Ebenholtz, S.M. Long-term enduranceof adaptative shifts in tonic accommodation. Ophthalmic Physiol. Opt. 8; 427-31,1988.

[8] ⁸
Fisher, S.K.; Ciuffreda, KJ.; Levine, S. Tonic accommodation, accommodative hysteresis, and refractive error. Am J. Optom. Physiol. Opt. 64: 799-809,1987.

[9] ⁹
Gilmartin, B. & Hogan, R The relationship between tonic accommodation and ciliary muscle innervation. Invest. Ophthalmol. Vis. Sci. 26: 1024-8, 1985.

[10] ¹⁰
Gilmartin, B.; Hogan, R.E.; Thompson, S.M. The effect of timolol maleate on tonic accommodation, tonic vergence, and pupildiameter. Invest. Ophthalmol. Vis. Sci. 25: 763-70, 1984.

[11] ¹¹
Heath, G.G. Components of accommodation. Am. J. Optom. Arch. Am. Acad. Optom. 33: 569-79, 1956.

[12] ¹²
Mcbrien, N.A. & Millodot, M. The relationship between tonic accommodation and refractive error. Invest. Ophthalmol. Vis. Sci. 28:997-1004, 1987.

[13] ¹³
Rosenfeld, M. Evaluation of clinical techniques to measure tonicaccommodation. Optom Vis. Sci. 66: 809-14,1989.

[14] ¹⁴
Rosner, J. & Rosner, J. Relation between clinically measured tonic accommodationand refractive status in 6- to 14- year-old children. Optom. Vis. Sci. 66: 436-9, 1989.

[15] ¹⁵
Leibowitz, H.W. & Owens, D.A. Anomalous myopias and the intermediated dark focus of accommodation. Science 189: 646-8,1975.

[16] ¹⁶
Gilmartin, B. A review of the role of sympathetic innervation of the ciliary muscle in ocularaccommodation. Clin. Vision Sci. 6: 23-37, 1986.

[17] ¹⁷
De Valois, R & De Valois, K. Spatial Vision, 1 st ed. Oxford: University Press, 1990.

[18] ¹⁸
Westheimer, G. Pupil size and visual resolution. Vision Res. 4: 39-45, 1964.

[19] ¹⁹
Charman, W.N. & Tucker, J. Dependence of accommodation response on the spatial frequency spectrum of the observed object. Vision Res. 17: 129-39, 1977.

[20] ²⁰
Cruz, A.A.V.; Tanaka, E.; Held, R Is tonic accommodation involved in the deterioration of accommodative esodeviations? J. Ped. Ophthalmol. Strab., 1992 (Submitted to publication).

[21] ²¹
Ward, P.a. & Channan, W.N. An objective assessement of the effect of fogging onaccommodation Am J. Optom. Physiol. Opt 64: 762-7,1987.

[22] ²²
Gilmartin, B. & Bullimore, M.A. Sustained nearvision augments inhibitory sympathetic innervation of the ciliary muscle. Clin. Vision Sci. 1: 197-208, 1987.

[23] ²³
Mcbrien, N.A. & Millodot, M. Differences in adaptation of tonic accommodation with refractive state. Invest. Ophthalmol. Vis. Sci. 29: 460-9, 1988.

[24] ²⁴
Jampolsky, A. A simplified approach to strabismus diagnosis. In: Symposium on strabismus, Transactions of the New Orleans Academy of Medicine. Saint Louis: Mosby, 1971, p. 35.

[25] ²⁵
Raab, E.L. Deterioration in accommodative esotropia. In: Strabismus II, edited by Reinecke RD. Orlando: Grune and Stratton, 1984, p. 213-222.

[26] ²⁶
Baker, J.D. &Parks, M.M. Early-onsetaccommodative esotropia. Am. J. Ophthalmol. 90: 11-8, 1980.

[27] ²⁷
Raab, E.L. Etiologicfactors in accommodative esodeviation. Tr. Am. Ophth. Soc. 80: 656-94, 1982.

[28] ²⁸
Von Noorden, G.K. Binocular vision and Ocular motility. Theory and management of strabismus, 4th ed. Saint Louis: Mosby, 1990.

[29] ²⁹
Parks, M.M. & Wheller, M.B. Concomitantesodeviations. In: Clinical Ophthalmology, edited by Duante T. D. Pennsylvania: Lippincott, vol. 1, 1988, p. 3.

[30] ³⁰
Dickey, C.F. & Scott, W.E. The deterioration of accommodative esotropia: frequency, characteristics, and predictive factors. J. Ped. Ophthalmol. Strab. 25: 172-4, 1988.

[31] ³¹
Ludwig, I.H.; Parks, M.M.; Getson, P.R.; Kammerman, L.A. Rate of deterioration in accommodative esotropia correlated to the AC/A relationship. J. Ped. Ophthalmol. Strab. 25: 8-12, 1988.

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