{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:23:32Z","timestamp":1772465012949,"version":"3.50.1"},"reference-count":109,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to investigate biometric variations in emmetropia and ametropia, focusing on the differences and correlations found in adult eyes. Bigaussian analyses were performed to characterise the biometric properties of the Regulated (or Emmetropised) and Dysregulated subpopulations identified in earlier works.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This work analyses the biometric and refractive error data of 2000 adult participants previously recruited during the first phase of the Shahroud Eye Cohort Study (Iran). Measurements included cycloplegic subjective refractive error, corneal radii of curvature and intraocular distances. The study employed multivariate bigaussian fits and statistical analyses to explore the relationships between ocular biometry parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant correlations were found between ocular dimensions, suggesting the existence of ocular shape factors. Meanwhile, there was a large overlap in biometric values across refractive groups, especially within \u00b13\u2009D. The 979 emmetropic eyes, defined as having a refractive error exceeding \u00b10.5\u2009D, had axial lengths ranging between 20.86 and 25.62\u2009mm, with matching corneal and lens powers that together ensured emmetropia. The distribution of both the refractive errors and the ocular biometry parameters was leptokurtic and skewed, and could be described accurately by a bigaussian function, representing the Regulated and Dysregulated subpopulations. Regulated eyes had well\u2010matched biometric parameters, while in Dysregulated eyes one or more deviations were seen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The terms refractive and axial ametropia are inadequate given the many interactions between ocular dimensions during eye growth, while emmetropisation is largely determined by the ability of the crystalline lens to lose power as the eye grows. \u2018Regulated\u2019 and \u2018Dysregulated\u2019 eyes are suitable alternatives, distinguished based on their relative biometry within a population. While the biometry of each eye is unique, large overlaps exist in the values of different refractive groups. These observations underscore the importance of using comprehensive rather than partial biometric data when studying or managing refractive errors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.13516","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T11:25:01Z","timestamp":1747653901000},"page":"1004-1024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Refractive development III: Variations in emmetropia and ametropia"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8124-8646","authenticated-orcid":false,"given":"Jos J.","family":"Rozema","sequence":"first","affiliation":[{"name":"Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences University of Antwerp  Wilrijk Belgium"},{"name":"Department of Ophthalmology Antwerp University Hospital  Edegem Belgium"},{"name":"Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1994-1105","authenticated-orcid":false,"given":"Mohammad Hassan","family":"Emamian","sequence":"additional","affiliation":[{"name":"Ophthalmic Epidemiology Research Centre Shahroud University of Medical Sciences  Shahroud Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6086-1537","authenticated-orcid":false,"given":"Hassan","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Noor Research Centre for Ophthalmic Epidemiology Noor Eye Hospital  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6438-6833","authenticated-orcid":false,"given":"Akbar","family":"Fotouhi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"On the anomalies of accommodation and refraction of the eye","author":"Donders F","year":"1864"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2023.02.002"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.13094"},{"key":"e_1_2_11_5_1","first-page":"23","article-title":"The Bakerian lecture. 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