{"doi":"10.1016/0275-5408(95)00020-e","title":"Accommodation and presbyopia","abstract":"<jats:title>Summary</jats:title>\n                  <jats:p>The mechanism of accommodation has been studied for at least four hundred years. The most interesting aspect of accommodation is that its time course is well in advance of other physiological functions – it begins to decline by adolescence and is lost about two‐thirds of the way through the normal line span. The state of presbyopia is reached when accommodation has declined sufficiently to interfere with close tasks requiring acute vision. Presbyopia is generally considered to originate with the ‘plant’ of the accommodative system, either within the lens and its capsule or within their support structures. One of the lenticular theories, the Hess–Gullstrand theory, is distinguished from other theories by its claim that as age increases there is an increasing excess amount of ciliary muscle contraction beyond the ability of the lens and capsule to respond to it. For all other theories, the maximum possible amount of ciliary muscle contraction is always necessary to produce maximum accommodation, at least beyond the age at which it reaches its peak. From my review of the present understanding of the mechanisms of accommodation and the theories of the development of presbyopia, I conclude that there is overwhelming evidence against the Hess–Gullstrand theory and that it is unlikely that changes in the ciliary muscle contractility contribute significantly to the development of presbyopia.</jats:p>","journal":null,"year":null,"id":666955,"datarank":0.7901787238594994,"base_score":5.267858159063328,"endowment":5.267858159063328,"self_citation_contribution":0.7901787238594994,"citation_network_contribution":0.0,"self_endowment_contribution":0.7901787238594994,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":193,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Accommodation and presbyopia","abstract":"<jats:title>Summary</jats:title>\n                  <jats:p>The mechanism of accommodation has been studied for at least four hundred years. The most interesting aspect of accommodation is that its time course is well in advance of other physiological functions – it begins to decline by adolescence and is lost about two‐thirds of the way through the normal line span. The state of presbyopia is reached when accommodation has declined sufficiently to interfere with close tasks requiring acute vision. Presbyopia is generally considered to originate with the ‘plant’ of the accommodative system, either within the lens and its capsule or within their support structures. One of the lenticular theories, the Hess–Gullstrand theory, is distinguished from other theories by its claim that as age increases there is an increasing excess amount of ciliary muscle contraction beyond the ability of the lens and capsule to respond to it. For all other theories, the maximum possible amount of ciliary muscle contraction is always necessary to produce maximum accommodation, at least beyond the age at which it reaches its peak. From my review of the present understanding of the mechanisms of accommodation and the theories of the development of presbyopia, I conclude that there is overwhelming evidence against the Hess–Gullstrand theory and that it is unlikely that changes in the ciliary muscle contractility contribute significantly to the development of presbyopia.</jats:p>","is_dataset_classified":null,"base_score":5.267858159063328,"endowment":5.267858159063328,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"7667018","pmcid":null,"openalex_id":"https://openalex.org/W1996867267","authors":[],"funders":[],"total_grants":0,"fwci":2.8324,"citation_percentile":0.89694773,"influential_citations":0,"citation_trend":[{"year":2012,"count":3},{"year":2013,"count":12},{"year":2014,"count":10},{"year":2015,"count":11},{"year":2016,"count":4},{"year":2017,"count":9},{"year":2018,"count":2},{"year":2019,"count":5},{"year":2020,"count":1},{"year":2021,"count":4},{"year":2022,"count":4},{"year":2023,"count":6},{"year":2024,"count":6},{"year":2025,"count":2}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1046%2Fj.1475-1313.1995.9500020e.x","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1475-1313.1995.9500020e.x","host_type":"publisher"},{"url":"https://doi.org/10.1016/0275-5408(95)00020-e","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/7667018","host_type":"repository"}],"fields_of_study":["Ophthalmology and Visual Impairment Studies","Intraocular Surgery and Lenses","Visual perception and processing mechanisms"],"mesh_terms":["Accommodation, Ocular","Adult","Aged","Aged, 80 and over","Aging","Ciliary Body","Humans","Lens, Crystalline","Middle Aged","Neural Pathways","Presbyopia"],"keywords":["Presbyopia","Accommodation","Ciliary muscle","Contractility","Optometry","Lens (geology)","Contraction (grammar)","Near vision","Lens capsule","Ciliary body","Ophthalmology","Psychology","Optics","Neuroscience","Medicine","Physics","Visual acuity","Internal medicine"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Sustainable cities and communities"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-13T16:07:32.349510Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}