No / The aims of the research may be outlined as follows: to measure the degree of transient axial elongation during the accommodation response in emmetropic and myopic young adults. To evaluate the effect of refractive error and accommodative demand on transient axial elongation of the eye. Axial length of the right eye was measured in 30 emmetropes and 30 myopes, by using the IOLMaster (Carl Zeiss Meditec, Inc., Dublin, CA), while accommodative stimuli of 0, 2, 4 and 6 D were presented with a Badal optometer. Axial length increased in both emmetropic and myopic subjects during short periods of accommodative stimulation. Greater transient increases in axial length were observed in myopic than in emmetropic subjects. The mean axial elongation with a 6-D stimulus to accommodation was 0.037 mm in emmetropes and 0.058 mm in myopes (P = 0.02). The degree of transient axial elongation correlated well with the stimulus to accommodation in emmetropes and myopes. Anterior chamber depth decreased, on average, by 0.19 mm in emmetropes and 0.18 mm in myopes when observing a 6-D stimulus to accommodation. During relatively short periods of accommodative stimulation, axial length increases in both emmetropic and myopic young adults. At higher levels of accommodative stimulation, a significantly greater transient increase in axial length is observed in myopic subjects than in their emmetropic counterparts.

The overarching theme of the thesis was to investigate the association between smart device use and computer vision syndrome. The initial study designed and developed the Open Field Tear film Analyser (OFTA) enabling a continuous, real-time assessment of the tear film and blink characteristics during smart device use. The monocular OFTA prototype was validated and showed good intra- and inter-observer repeatability relative to the Oculus Keratograph 5M and Bausch and Lomb one position keratometer. Subsequently, tear osmolarity following engagement with reading and gaming tasks on smart device and paper platforms was investigated. Discrete measures of osmolarity pre- and post-engagement with the tasks were obtained with the TearLab osmometer; osmolarity values differed between platforms when participants were engaged in a gaming task but no such difference was observed with the reading task. In addition, the influence of repeated measurements on tear osmolarity was also explored. To simulate the habitual binocular viewing conditions normally associated with smart device use, the binocular OFTA was developed. The device was used to assess the tear film and blink characteristics whilst engaging with reading and gaming tasks on smart device and paper platforms. The results revealed differences in blink characteristics and non-invasive tear break up time between the different platforms and tasks assessed. In addition, the thesis also reports on an investigation examining the real-time accommodative response to various targets displayed on smart devices using an open-field autorefractor with a Badal lens system adaptation. The results showed that accommodative latency, accommodative lag, mean velocity of accommodation, speed of disaccommodation and mean velocity of disaccommodation varied across the different platforms. Through the use of validated subjective questionnaires and smartphone apps, the relationship between duration of smartphone use and symptoms of dry eye were examined. The findings of this study demonstrated that longer duration of smartphone and personal computer use were associated with higher risk of dry eyes as indicated by subjective questionnaire outcomes.