Accommodative microfluctuations (AMFs) are temporal variations in the accommodative response. AMFs can be divided into two categories, the low frequency component (LFC) measuring below 0.6 Hz and the high frequency component (HFC) measuring between 1.0 and 2.3 Hz. This thesis examined occupational factors that may affect AMFs comprising of cognitive demand, visual fatigue and the type of digital display used. These effects were measured by assessing changes in the LFC, mid frequency component (MFC), HFC, and RMS accommodation. Analysis of chaos and the overall accommodative response (AR) was also used. Furthermore, an investigation into inter- and intra-participant variability was completed. The HFC was shown to increase in line with increasing cognitive demand. A significant effect for task duration was found at higher accommodative demands for the overall AR, LFC and MFC. There was a significant effect on the LFC and AR depending on the type of display used during near work. The HFC and MFC were found to be less repeatable in the same participant relative to LFC, RMS accommodation and AR measurements. AMFs appear to have an effect on occupational factors, however more research is required to assess how much of an effect they may have relative to other ocular factors that affect occupational settings.

Yes / Background: Soft contact lenses have been developed and licensed for reducing myopia progression. These lenses have different designs, such as extended depth of focus (EDOF) and dual focus (DF). In this prospective, doublemasked, cross-over study, different lens designs were investigated to see whether these had impact on accommodative microfluctuations and eye movements during reading. Methods: Participants were fitted with three lenses in a randomised order; a single vision (SV) design (Omafilcon A2; Proclear), a DF design (Omafilcon A2; MiSight), and an EDOF lens design (Etafilcon A; NaturalVue),. Accommodative microfluctuations were measured at 25 cm for at least 60s in each lens, using a Shin-Nippon SRW-5000 autorefractor adapted to continuously record accommodation at 22Hz. Eye movement data was collected with the Thomson Clinical Eye Tracker incorporating a Tobii Eye bar. Eye movements include fixations per row, fixations per minute, mean regressions per row, total number of regressions, and total rightward saccades. Accommodation data was analysed using power spectrum analysis. Differences between the lenses were compared using a related sample two-way Friedman test. Results: Twenty-three participants (18–29 years) were recruited to take part. The average mean spherical error was − 2.65D ± 1.42DS, with an average age of 23.4 ± 3.5 years. No significant difference for accommodative microfluctuations was found. Significant differences were found for fixations per row (P = 0.03), fixations per minute (P = 0.008), mean regressions per row (P = 0.002), and total number of regressions (P = 0.002), but not total rightward saccades (P = 0.10). Post-hoc analysis indicated the EDOF lens results were significantly different from the other lenses, with more regressive eye movements observed. Conclusions: Regressive saccades appear to increase when wearing EDOF lens designs, which may impact visual comfort. Further studies in children, over a longer period of adaptation are necessary to assess the potential impact of this finding on daily reading activities in children. / This project was supported by the British Contact Lens Association Summer Studentship Award (recipient Muskaan Hussain).