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Anti-accommodation in anisometropic amblyopia


Project Description

Accommodation has always been considered to be a symmetrical process, with each eye accommodating an equal amount, even in anisometropia. More recently, there has been evidence of “anti-accommodation” in anisometropia [1, 2], where the sound eye accommodates appropriately for the target distance but the amblyopic eye accommodates in the wrong direction, with greater accommodation in the distance than at near. This novel finding occurs in approximately 25% of children with anisometropic amblyopia [2]. A case report [1] reveals a possible association between the presence of anti-accommodation and a poor response to amblyopia treatment. The accommodation response has previously never been considered as a possible risk factor for the failure of amblyopia treatment. Is there an association between these two factors?

In these recent studies, anti-accommodation was detected using a Plusoptix photorefractor but this is not readily available in clinics. Can anti-accommodation be detected using dynamic retinoscopy? Patients will be tested using both methods to determine if the results can be translated into clinical practice.

We have unpublished evidence that anti-accommodation persists into adulthood but we also have evidence that it can resolve. Can those with anti-accommodation be taught to accommodate symmetrically? If so, does this improve vision in the amblyopic eye? This PhD will involve determining changes that can be made to amblyopia treatment plans and monitoring the impact this has on accommodation and vision. The outcomes of this project could have a clinical impact on future Orthoptic treatment.

1. Horwood AM, Riddell PM. Independent and reciprocal accommodation in anisometropic amblyopia. J AAPOS 2010; 14(5): 447-9. http://doi.org/10.1016/j.jaapos.2010.07.003
2. Toor S, Horwood AM, Riddell PM. Asymmetrical accommodation in hyperopic anisometropic amblyopia. Br J Ophthalmol 2018; 102(6): 772-8. http://doi.org/10.1136/bjophthalmol-2017-310282

The PhD is particularly suited to Orthoptists. Candidates from other relevant backgrounds such as Optometry, Vision Science and Ophthalmology are also welcome to apply.

If you have any questions about the project or are planning to submit an application, please contact one of the supervisors:
Dr Sonia Toor ()
Dr Charlotte Codina ()
Unit of Ophthalmology and Orthoptics
https://www.sheffield.ac.uk/oncology-metabolism/research/ophthalmology-orthoptics/research

Funding Notes

This project is open to self-funded students only.

Entry Requirements:
Candidates must have a first or upper second class honors degree or significant research experience.

References

Enquiries:
Interested candidates should in the first instance contact Sonia Toor, [email protected]

How to apply:
Please complete a University Postgraduate Research Application form available here: www.shef.ac.uk/postgraduate/research/apply

Please clearly state the prospective main supervisor in the respective box and select Oncology and Metabolism as the department.

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