Simultaneous measurement of objective refraction, accommodation response and axial length of the human eye.

Purpose: Accurate measurements of ocular biometry and objective refraction are of vital importance to research laboratories working in the area of refractive error development and oculomotor function. A number of commercially available instruments can provide these measurements, and are used in both their intended modes, and with modifications to increase their research utility. A limitation that exists currently is the inability to conduct simultaneous measurements of refractive error or accommodation response, and the axial length of the same eye. In this technical note we provide details of a method to adapt the Zeiss IOLMaster and the Shin-Nippon SRW-5000 infrared optometer to simultaneously measure refraction and axial length.

Methods: The optical modification used to combine the measurement paths of the IOLMaster and SRW-5000 instruments consists of a narrow band-pass filter, and optical relay to extend the working distance of the IOLMaster, and an electronic system to provide synchronisation between the IOLMaster and the SRW-5000 continuous accommodation recording system. The optical modification was tested on model eyes, and on a cohort of 20 human eyes. The combined system was then used to measure accommodation response and axial length simultaneously in a single participant.

Results: Inclusion of the optical modification in the IOLMaster pathway induced a 0.004 mm shift in the average measurement of a calibration eye, and an average difference of 0.001 mm for a cohort of human eyes. For the SRW-5000, inclusion of the modified optics induced a +0.15 D shift in the spherical component of refraction measurements made on a model eye, and an average shift of +0.12 D in the spherical component of measurements made on a cohort of human eyes. Simultaneous measurement of accommodation response and axial length in a single participant revealed that a change in stimulus vergence from 0 to 5 D caused an average accommodation response of 3.89 D, and an average transient axial length change of 0.059 mm.

Conclusions: The system described provides a useful method of achieving simultaneous measurements of axial length, objective refraction and accommodation response in a human eye.