Author: Irene Sisó Fuertes, University of Manchester

Usually accommodation is treated as a static process but it is not. During an accommodative response the refractive power undergoes small amplitude fluctuations. These fluctuations in accommodative response increase during accommodation and decrease with advancing age.

There exists a controversy when it comes to the mechanism and significance of the fluctuations. It is still uncertain whether they simply represent a background noise of the accommodative system or play a role in the accommodation steady-state, maintaining focus and retinal contrast whilst fixating on a fixed target. Therefore, studies that look into the impact of microfluctuations of accommodation and other higher order aberrations on the retinal image quality are warranted on a large age range of patients to understand their role in the eye further.