Current aspects of studying accommodation disorders in the context of autonomic nervous regulation
https://doi.org/10.21516/2072-0076-2025-18-2-173-178
Abstract
Habitual excessive accommodation tension (HEAT) in children is associated with ciliary muscle spasm, reduced distance visual acuity, and asthenopic symptoms. Studies highlight the role of the autonomic nervous system (ANS) in accommodation regulation, while an imbalance between sympathetic and parasympathetic activity, triggered by stress and visual load, may contribute to the development of HEAT. Modern diagnostic methods, such as heart rate variability and pupillometry, enable the study of ANS influence on accommodation. Various correction approaches are considered, including pharmacological and physiotherapeutic methods, as well as restoring autonomic balance. Further research is needed to explore the impact of the ANS on accommodation in children.
About the Authors
A. Zh. Fursova
Novosibirsk Regional Clinical Hospital; Novosibirsk State Medical University
Russian Federation
Russian Federation
Anzhella Zh. Fursova — Dr. of Med. Sci., head of the ophthalmological department, Novosibirsk Regional Clinical Hospital; head of chair of ophthalmology, Novosibirsk State Medical University.
130, Nemirovich-Danchenko St., Novosibirsk, 630087; 52, Krasny Prospect, Novosibirsk, 630091
M. K. Artykova
City Clinical Polyclinic # 29
Russian Federation
Russian Federation
Manizha K. Artykova — ophthalmologist of the children's outpatient department.
1, Rassvetnaya St., Novosibirsk, 630129
References
1. Bharadwaj SR, Roy S, Satgunam PN. Spasm of near reflex: objective assessment of the near-triad. Invest Ophthalmol Vis Sci. 2020; 61 (8): 18–18. doi: https://doi.org/10.1167/iovs.61.8.18
2. Papageorgiou E, Kardaras D., Kapsalaki E. et al. Spasm of the near reflex: a common diagnostic dilemma? Int J Ophthalmol. 2021; 14 (4): 541. doi: 10.18240/ijo.2021.04.10
3. Tarutta E.P., Proskurina O.V., Tarasova N.A., Markosyan G.A. Risk factors for myopia development in preschool and early school age and its prevention measures. Rus. Ped. Ophth. 2019; 14 (1): 25–33 (In Russ.). doi: 10.17816/1993-1859-2019-14-1-4-25-33
4. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016; 123 (5): 1036–42. doi: 10.1016/j.ophtha.2016.01.006
5. Tarutta E.P., Iomdina E.N., Tarasova N.A., Markosyan G.A., Maksimova M.V. Comprehensive approach to the prevention and treatment of progressive myopia in schoolchildren. RMJ. Clinical Ophthalmology. 2018; 18 (2): 70–6 (In Russ.).
6. Proskurina O.V., Markova E.Y., Brzhesky V.V., et al. Prevalence of myopia in schoolchildren from some regions of Russia. Ophthalmology. 2018; 15 (3): 348–53 (In Russ.). doi.org/10.18008/1816-5095-2018-3-348-353
7. DL A, Raju TR. Autonomic nervous system and control of visual function. Ann Neurosci. 2023; 30 (3): 151–3. doi.org/10.1177/09727531231176119
8. Ferencova N, Visnovcova Z, Olexova L.B, et al. Eye pupil – a window into central autonomic regulation via emotional/cognitive processing. Physiol Res. 2021; 70 (l4): 669–82. doi:10.33549/physiolres.934749
9. Dukhayer S, Bushuieva NM, Slobodianyk SB. Pupil response to accommodation and convergence in healthy children and adolescents of various age groups and autonomic nervous system tone. Journal of Ophthalmology. 2020; 85 (2): 36–44. doi: 10.31288/oftalmolzh202023644
10. Aprelev A.E., Setko N.P., Pashinina R.V., Iserkepova A.M., Yasin I.A. Dysfunction of the autonomic nervous system as a risk factor for myopia development and progression. Med. Bulletin of Bashkortostan. 2016; 11 (1): 157–9 (In Russ.).
11. Mihelcic M, Podlesek A. Cognitive workload affects ocular accommodation and pupillary response. J Optom. 2023; 16 (2): 107–15. doi.org/10.1016/j.optom.2022.05.001
12. Dybova A.V., Ragulina M.V. Influence of psychological aspects of general stress on the habitual excessive tone of ciliary muscle accommodation in adolescents. Psych. science and practice in modern society. 2021: 114–20 (In Russ.).
13. Iomdina E.N., Tarutta E.P., Markosyan G.A. et al. Variations of the Kerdo index as an indicator of the balance of the autonomic nervous system in children and adolescents with progressive myopia. Glaz. 2013; 2: 22–5 (In Russ.).
14. Cherednichenko N.L. Influence of physical activity on accommodation state, refractogenesis, and autonomic nervous system regulation in children and adolescents. Med. Bulletin of the North Caucasus. 2016; 11 (3): 468–70. (In Russ.). doi: 10.14300/mnnc.2016.11107
15. May PJ, Reiner A, Gamlin PD. Autonomic regulation of the eye. Oxford Res Encycl Neurosci. 2019. doi.org/10.1093/acrefore/9780190264086.013.276
16. Motlagh M, Geetha R. Physiology, accommodation [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK542189/
17. Wu F, Zhao Y, Zhang H. Ocular autonomic nervous system: an update from anatomy to physiological functions. Vision. 2022; 6 (1):6. doi.org/10.3390/vision6010006
18. Ampolu N, Yarravarapu D, Satgunam P, et al. Impact of induced pseudomyopia and refractive fluctuations of accommodative spasm on visual acuity. Clin Exp Optom. 2023; 106 (8): 876–82. doi.org/10.1080/08164622.2022.2140583
19. Umemoto R, Hashimoto Y, Imabayashi S, et al. Changes in choroidal thickness in healthy participants after induction of sympathetic hyperactivity using the cold pressor test. Graefes Arch Clin Exp Ophthalmol. 2023; 261 (2): 585–7. doi:10.1007/s00417-022-05820-5
20. Lin S, Zhu B, Wang T, et al. Sympathetic nervous system activity is associated with choroidal thickness and axial length in school-aged children. Br J Ophthalmol. 2024; 108 (3): 405–10. doi.org/10.1136/bjo-2022-322165
21. Baikoff G. Measurement of accommodation. In: Anterior Segment Optical Coherence Tomography. CRC Press; 2024: 139–46.
22. Chung I. Testing accommodation in children. In: The Pediatric Eye Exam Quick Reference Guide: Office and Emergency Room Procedures. IGI Global; 2022: 200–21. doi: 10.4018/978-1-7998-8044-8.ch010
23. Rucker F, Taylor C, Kaser-Eichberger A, et al. Parasympathetic and sympathetic control of emmetropization in chick. Exp Eye Res. 2023; 232: 109508. doi.org/10.1016/j.exer.2023.109508
24. Katargina L.A., Tarutta E.P., Proskurina O.V., et al. Accommodation: on the issue of terminology. Russian ophthalmological journal. 2011; 4 (3): 93–4 (In Russ.).
25. Tarutta E.P., Tarasova N.A. Criteria for diagnosing habitual excessive accommodation tension based on subjective and objective accommodation parameters. Russian Pediatric Opthalmology. 2013; 1: 34–8 (In Russ.).
26. Morozova T.A., Pikusova S.M. Habitual excessive accommodation tension: current state of the problem. Bulletin of the Russian Academy of Medical Sciences. 2024; 79 (5): 453–62 (In Russ.). doi.org/10.15690/vramn17955
27. Garc a-Montero M, Felipe-M rquez G. Pseudomyopia: a review. Vision. 2022; 6 (1): 17. doi.org/10.3390/vision6010017
28. Hilora M, Tripathy K. Accommodative Excess. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. PMID: 37276314.
29. Andrianov V.V., Vasilyuk N.A., Biryukova E.V., Kazakova V.V. Autonomic and psychophysiological indicators of students during academic computer testing. Academic Journal of Western Siberia. 2014; 10 (3): 49 (In Russ.).
30. Lin Z, Vasudevan B., Liang Y. B, et al. The association between nearwork-induced transient myopia and progression of refractive error: a 3-year cohort report from Beijing myopia progression study. J Optom. 2021; 14 (1): 44–9. doi.org/10.1016/j.optom.2020.05.004
31. Dutheil F, Oueslati T, Delamarre L, et al. Myopia and near work: a systematic review and meta-analysis. Int J Environ Res Public Health. 2023; 20 (1): 875. doi.org/10.3390/ijerph20010875
32. Aprelev A.E., Setko N.P., Karaulova E.S., et al. Dependence of accommodation volume on the predominant type of autonomic tone of the central nervous system in students with different degrees of myopia. Medical Bulletin of Bashkortostan. 2015; 10 (2): 88–91 (In Russ.).
33. Fedorishcheva L.E., Eremenko K.Y., Aleksandrova N.N. Comparative analysis of accommodation tension in primary school children depending on emotional state. Ophthalmology. 2014; 10 (3): 54–7 (In Russ.).
34. Yamaguchi J, Kinoshita K., Hosokawa T, et al. The eyes are the windows of the soul: Portable automated pupillometry to monitor autonomic nervous activity in CO2 narcosis: A case report. Medicine. 2023; 102 (19): E33768. doi: 10.1097/MD.0000000000033768
35. Kurtieva S. Physical performance assessment in adolescents with autonomic dysfunction. Int J Med Sci Clin Res Stud. 2021; 1 (6): 143–6. doi.org/10.47191/ijmscrs/v1-i6-04
36. Moscatelli F, Sessa F, Valenzano A, et al. The influence of physical exercise, stress and body composition on autonomic nervous system: A narrative review. Sport Mont. 2022; 20 (2): 131–4. doi: 10.26773/smj.220620
37. Tarutta E.P., Tarasova N.A., Markosian G.A., et al. Changes in functional, anatomical and optical parameters of the eye in children with habitually excessive accommodation stress and pseudomyopia after regular badminton playing. Russian ophthalmological journal. 2019; 12 (4): 51–63 (In Russ.). https://doi.org/10.21516/2072-0076-2019-12-4-51-63
38. Vera J, Luque-Casado A., Redondo B, et al. Ocular accommodative response is modulated as a function of physical exercise intensity. Curr Eye Res. 2019; 44 (4): 442–50. doi.org/10.1080/02713683.2018.1557210c
39. Bufo MR, Guidotti M, De Faria C, et al. Autonomic tone in children and adults: Pupillary, electrodermal and cardiac activity at rest. Int J Psychophysiol. 2022; 180: 68–78. doi.org/10.1016/j.ijpsycho.2022.07.009
40. Artamonova SY, Ammosova AM, Stepanova LA, et al. Features of vegetative homeostasis in teenagers with myopia. In: Conference on Health and Wellbeing in Modern Society (CHW 2021). Atlantis Press; 2022: 21–5. doi: 10.2991/ahsr.k.220103.005
41. Redondo B, Vera J., Luque-Casado A, et al. Associations between accommodative dynamics, heart rate variability and behavioural performance during sustained attention: A test-retest study. Vision Res. 2019; 163: 24–32. doi.org/10.1016/j.visres.2019.07.001
42. Rockswold SB, Burton PC, Chang A, et al. Functional magnetic resonance imaging and oculomotor dysfunction in mild traumatic brain injury. J Neurotrauma. 2019; 36 (7): 1099–105. doi.org/10.1089/neu.2018.5796
43. Dukhayer Sh., Bushuieva N.N., Slobodianyk S.B. Features of diagnosing accommodation spasm in children considering autonomic nervous system tone using pupillography with mydriatic instillation. Ophthalmology. Eastern Europe. 2020; 10 (1): 96–104 (In Russ.). doi: 10.34883/PI.2020.10.1.011
44. Tarutta E.P., Kiseleva T.N., Tarasova N.A., Epishina M.V. Changes in accommodation parameters and hemodynamic indicators in eye vessels during hardware treatment of myopia. Russian Pediatric Opthalmology. 2014; 1: 42–5 (In Russ.).
45. Sheng Y, Zhu L. The crosstalk between autonomic nervous system and blood vessels. Int J Physiol Pathophysiol Pharmacol. 2018; 10 (1): 17.
46. Tarutta E.P., Iomdina E.N., Tarasova N.A., Filinova O.B. The effect of 2.5% Irifrin on accommodation parameters and refraction dynamics in patients with progressive myopia. Russian ophthalmological journal. 2010; 3 (2): 30–3 (In Russ.).
47. Dukhayer Sh., Bushuieva N.N., Slobodianyk S.B. Results of drug treatment of patients with accommodation disorders considering autonomic innervation balance and pupillography data. Ophthalmological journal. 2018; (6): 10–8 (In Russ.). doi: 10.31288/oftalmolzh201861018
48. Collins MJ, Hoseini-Yazdi H, Read SA, et al. Non-pharmacological stimulation of the autonomic nervous system and short-term changes in axial length. Invest Ophthalmol Vis Sci. 2024; 65 (7): 2712. https://iovs.arvojournals.org/article.aspx?articleid=2794667
49. Dubko D.A., Egorov V.V., Smolyakova G.P. Clinical efficacy of various physiotherapeutic methods in children with school myopia depending on the neurovegetative state. Modern Techn. in Ophthalmol. 2017; 4: 68–71 (In Russ.).
50. Kashchenko T.P., Raigorodsky Yu.M., Uvarova G.I., Kornyushina T.А. Hardware sympatocorrection in the treatment of accommodation disorders and myopia in children. Physiotherapy, balneology and rehabilitation. 2015; 14 (5): 25–30 (In Russ.).
51. Bruno RM, Ghiadoni L. Polyphenols, antioxidants and the sympathetic nervous system. Curr Pharm Des. 2018; 24 (2): 130–9. doi: 10.2174/1381612823666171114170642
52. Daniela M, Catalina L, Ilie O, et al. Effects of exercise training on the autonomic nervous system with a focus on anti-inflammatory and antioxidant effects. Antioxidants. 2022; 11 (2): 350. doi.org/10.3390/antiox11020350
53. Wadhwania R. Is Vitamin D deficiency implicated in autonomic dysfunction? J Pediatr Neurosci. 2017; 12 (2): 119–23. doi: 10.4103/jpn.JPN_1_17
54. Bocharin I, Eshiev A, Guryanov M, et al. Results of using a plant adaptogen to improve the functional state of athletes. J Phys Educ Sport. 2024; 24 (11): 1884–91. https://www.efsupit.ro/images/stories/november2024/Art%20284.pdf
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For citations:
Fursova A.Zh., Artykova M.K. Current aspects of studying accommodation disorders in the context of autonomic nervous regulation. Russian Ophthalmological Journal. 2025;18(2):173-178. (In Russ.) https://doi.org/10.21516/2072-0076-2025-18-2-173-178
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