Abstract/Summary

Aim Clear near vision would seem vital for education. Existing literature has suggested an association between accommodation and education. However, this evidence base is limited and conflicting. Furthermore, a causal relationship between accommodation response (AR) and education has not been shown to date. This PhD thesis was funded by Fight for Sight charity as a “first step” to investigate typical accommodation in primary school children and establish if a relationship exists between accommodation and education. Should a relationship be identified, the results were designed to provide pilot data for further research to investigate causality. Methods Three studies were conducted: 1. A qualitative study, involving parents of primary school children, explored parental concerns regarding accommodation research. 2. During a controlled laboratory based study AR to a range of targets was objectively assessed using the Plusoptix PowerRefII photorefractor. The relationship between AR and academic ability markers was analysed; providing pilot data for a school based study. 3 A purpose built portable laboratory (incorporating a Plusoptix R09 photorefractor) was used to asses AR in participants, from a range of socio-economic backgrounds, to various targets in a community (school based) setting. AR was analysed in relation to reading and attention. xvii Results The qualitative study established that parents would be willing to participate in future accommodation research but exposed concerns regarding research duration. In both the laboratory and school studies increased AR was observed in response to complex targets. Accommodation was not related to performance on educational tests. Conclusions AR is influenced by target type. Under naturalistic conditions typical children will exert increased accommodation to more cognitively demanding targets. Accommodation does not appear correlated to reading ability or attention. Even very able readers appear to function with a degree of accommodative lag.