{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:02:46Z","timestamp":1791928966835,"version":"4.3.4"},"reference-count":64,"publisher":"Association for Research in Vision and Ophthalmology (ARVO)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Invest. Ophthalmol. Vis. Sci."],"published-print":{"date-parts":[[2026,6,26]]},"DOI":"10.1167\/iovs.67.6.52","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T13:32:41Z","timestamp":1782480761000},"page":"52","source":"Crossref","is-referenced-by-count":0,"title":["Reduced Image Quality Impairs Monocular Blur-Driven Accommodation in Keratoconus"],"prefix":"10.1167","volume":"67","author":[{"given":"Tithi","family":"Bhakta","sequence":"first","affiliation":[{"name":"Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Telangana, India"},{"name":"Brien Holden Institute of Optometry and Vision Sciences, L. V. Prasad Eye Institute, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketakee","family":"Jain","sequence":"additional","affiliation":[{"name":"Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Telangana, India"},{"name":"Brien Holden Institute of Optometry and Vision Sciences, L. V. Prasad Eye Institute, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Sudanabonia","sequence":"additional","affiliation":[{"name":"Cataract and Refractive Services, L. V. Prasad Eye Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Sager","sequence":"additional","affiliation":[{"name":"Laboratorio de Optica, Universidad de Murcia, Murcia (Regi\u00f3n de Murcia), Spain"},{"name":"Voptica, Universidad de Murcia, Murcia (Regi\u00f3n de Murcia), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Gambin","sequence":"additional","affiliation":[{"name":"Laboratorio de Optica, Universidad de Murcia, Murcia (Regi\u00f3n de Murcia), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Artal","sequence":"additional","affiliation":[{"name":"Laboratorio de Optica, Universidad de Murcia, Murcia (Regi\u00f3n de Murcia), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrikant R.","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Telangana, India"},{"name":"Brien Holden Institute of Optometry and Vision Sciences, L. V. Prasad Eye Institute, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27","reference":[{"issue":"2025","key":"bib1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1146\/annurev-vision-110623-080628","article-title":"Ocular accommodation: the autofocus mechanism of the human eye","volume":"11","author":"Bharadwaj","year":"2025","journal-title":"Annu Rev Vis Sci"},{"issue":"4","key":"bib2","doi-asserted-by":"publisher","first-page":"3.1","DOI":"10.1167\/10.4.3","article-title":"Estimation of the depth of focus from wavefront measurements","volume":"10","author":"Yi","year":"2010","journal-title":"J Vis."},{"issue":"14","key":"bib3","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1016\/j.visres.2011.05.006","article-title":"Depth of focus and visual acuity with primary and secondary spherical aberration","volume":"51","author":"Yi","year":"2011","journal-title":"Vision Res"},{"issue":"12","key":"bib4","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1016\/j.jcrs.2010.07.022","article-title":"Subjective depth of field in presence of 4th-order and 6th-order Zernike spherical aberration using adaptive optics technology","volume":"36","author":"Benard","year":"2010","journal-title":"J Cataract Refract Surg"},{"issue":"5","key":"bib5","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1097\/OPX.0b013e3181d95217","article-title":"Visual impact of Zernike and Seidel forms of monochromatic aberrations","volume":"87","author":"Cheng","year":"2010","journal-title":"Optom Vis Sci"},{"issue":"6","key":"bib6","doi-asserted-by":"publisher","first-page":"4.1","DOI":"10.1167\/9.6.4","article-title":"Accommodative lag and fluctuations when optical aberrations are manipulated","volume":"9","author":"Gambra","year":"2009","journal-title":"J Vis"},{"issue":"4","key":"bib7","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/OPX.0b013e318249d727","article-title":"Aberrations and topography in normal, keratoconus-suspect, and keratoconic eyes","volume":"89","author":"Gordon-Shaag","year":"2012","journal-title":"Optom Vis Sci"},{"issue":"11","key":"bib8","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1016\/j.ophtha.2007.01.008","article-title":"Characterizing the wave aberration in eyes with keratoconus or penetrating keratoplasty using a high-dynamic range wavefront sensor","volume":"114","author":"Pantanelli","year":"2007","journal-title":"Ophthalmology"},{"issue":"1","key":"bib9","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1038\/s41598-020-57993-w","article-title":"A computational analysis of retinal image quality in eyes with keratoconus","volume":"10","author":"Nilagiri","year":"2020","journal-title":"Sci Rep"},{"issue":"5","key":"bib10","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1167\/9.5.6","article-title":"Visual performance after correcting higher order aberrations in keratoconic eyes","volume":"9","author":"Sabesan","year":"2009","journal-title":"J Vis"},{"issue":"2","key":"bib11","first-page":"186","article-title":"Insufficient accommodation in patient with keratoconus","volume":"94","author":"Ohmi","year":"1990","journal-title":"Nippon Ganka Gakkai Zasshi"},{"issue":"6","key":"bib12","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1097\/OPX.0000000000001517","article-title":"Spectrum of binocular vision anomalies in keratoconus subjects","volume":"97","author":"Dandapani","year":"2020","journal-title":"Optom Vis Sci"},{"key":"bib13","doi-asserted-by":"crossref","first-page":"S50","DOI":"10.1097\/ICL.0000000000000317","article-title":"Change in accommodation and ocular aberrations in keratoconus patients fitted with scleral lenses","volume":"44 Suppl 1","author":"Yildiz","year":"2018","journal-title":"Eye Contact Lens"},{"issue":"2","key":"bib14","doi-asserted-by":"publisher","first-page":"101794","DOI":"10.1016\/j.clae.2022.101794","article-title":"Computational analysis of retinal image quality with different contact lens designs in keratoconus","volume":"46","author":"Devi","year":"2023","journal-title":"Cont Lens Anterior Eye"},{"issue":"7","key":"bib15","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1111\/opo.70037","article-title":"Impact of contact lens correction on wavefront aberrations and vision quality in keratoconus","volume":"45","author":"Swartz","year":"2025","journal-title":"Ophthalmic Physiol Opt"},{"issue":"13","key":"bib16","first-page":"3774","article-title":"Abnormal fluctuations of the accommodation in patients with mild keratoconus","volume":"55","author":"Miyakoshi","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"3","key":"bib17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.33791\/2222-4408-2022-3-7-14","article-title":"Objective study of accommodation in keratoconus","volume":"24","author":"Averich","year":"2022","journal-title":"EYE GLAZ."},{"issue":"4","key":"bib18","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1111\/opo.12619","article-title":"Calculation of the geometrical point-spread function from wavefront aberrations","volume":"39","author":"Thibos","year":"2019","journal-title":"Ophthalmic Physiol Opt"},{"issue":"4","key":"bib19","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1136\/bjophthalmol-2017-311651","article-title":"Evaluation of keratoconus progression","volume":"103","author":"Shajari","year":"2019","journal-title":"Br J Ophthalmol"},{"issue":"10","key":"bib20","doi-asserted-by":"publisher","first-page":"4017","DOI":"10.1364\/BOE.570747","article-title":"Binocular adaptive optics visual simulator with convergence control","volume":"16","author":"Sager","year":"2025","journal-title":"Biomed Opt Express"},{"issue":"4","key":"bib21","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1163\/156856897X00357","article-title":"The Psychophysics Toolbox","volume":"10","author":"Brainard","year":"1997","journal-title":"Spat Vis."},{"issue":"5","key":"bib22","doi-asserted-by":"publisher","first-page":"S652","DOI":"10.3928\/1081-597X-20020901-30","article-title":"Standards for reporting the optical aberrations of eyes","volume":"18","author":"Thibos","year":"2002","journal-title":"J Refract Surg"},{"issue":"9","key":"bib23","doi-asserted-by":"publisher","first-page":"9793","DOI":"10.1364\/OE.25.009793","article-title":"Chromatic aberration control with liquid crystal spatial phase modulators","volume":"25","author":"Martinez","year":"2017","journal-title":"Opt Express"},{"issue":"13","key":"bib24","doi-asserted-by":"publisher","first-page":"6213","DOI":"10.1364\/OE.14.006213","article-title":"Chromatic aberration correction of the human eye for retinal imaging in the near infrared","volume":"14","author":"Fern\u00e1ndez","year":"2006","journal-title":"Opt Express"},{"issue":"6","key":"bib26","doi-asserted-by":"crossref","first-page":"503","DOI":"10.4103\/0301-4738.103773","article-title":"Revisiting the impact of phenylephrine hydrochloride on static and dynamic accommodation","volume":"60","author":"Sarkar","year":"2012","journal-title":"Indian J Ophthalmol"},{"issue":"4","key":"bib27","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1167\/4.4.9","article-title":"Accuracy and precision of objective refraction from wavefront aberrations","volume":"4","author":"Thibos","year":"2004","journal-title":"J Vis"},{"issue":"13","key":"bib28","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1167\/13.13.28","article-title":"Change in visual acuity is well correlated with change in image-quality metrics for both normal and keratoconic wavefront errors","volume":"13","author":"Ravikumar","year":"2013","journal-title":"J Vis"},{"issue":"1","key":"bib29","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S0042-6989(99)00156-X","article-title":"Monochromatic aberrations in the accommodated human eye","volume":"40","author":"He","year":"2000","journal-title":"Vision Res"},{"issue":"4","key":"bib30","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1167\/4.4.3","article-title":"A population study on changes in wave aberrations with accommodation","volume":"4","author":"Cheng","year":"2004","journal-title":"J Vis"},{"issue":"7","key":"bib31","doi-asserted-by":"publisher","first-page":"11.11","DOI":"10.1167\/7.7.11","article-title":"Age-related changes in ocular aberrations with accommodation","volume":"7","author":"Radhakrishnan","year":"2007","journal-title":"J Vis"},{"issue":"1","key":"bib32","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12886-025-03947-7","article-title":"Change in monochromatic aberrations with accommodation in a large adult population","volume":"25","author":"Mech\u00f3-Garc\u00eda","year":"2025","journal-title":"BMC Ophthalmol"},{"issue":"2","key":"bib33","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1111\/j.1475-1313.2006.00364.x","article-title":"Accommodation and the relationship to subjective symptoms with near work for young school children","volume":"26","author":"Sterner","year":"2006","journal-title":"Ophthalmic Physiol Opt"},{"issue":"16","key":"bib34","doi-asserted-by":"publisher","first-page":"3136","DOI":"10.1038\/s41433-024-03251-6","article-title":"Impacts of keratoconus on quality of life: a qualitative study","volume":"38","author":"Fan","year":"2024","journal-title":"Eye"},{"issue":"4","key":"bib35","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1167\/iovs.66.4.31","article-title":"Depth-related visuomotor performance in keratoconus and its relationship to stereopsis","volume":"66","author":"Devi","year":"2025","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"bib36","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1097\/ICO.0000000000003935","article-title":"Ophthalmic quality of life and its association with visual function, accommodative and binocular vision performance in keratoconus patients: a study using Rasch analysis?","author":"Rafiei","year":"2026;45","journal-title":"Cornea"},{"issue":"1","key":"bib37","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/s44402-026-00022-6","article-title":"Evaluation of factors influencing quality of life in keratoconus patients using the Keratoconus Outcomes Research Questionnaire (KORQ)","volume":"46","author":"Ferrini","year":"2026","journal-title":"Ophthalmic Physiol Opt"},{"issue":"3","key":"bib38","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1113\/jphysiol.1965.sp007784","article-title":"Optical and retinal factors affecting visual resolution","volume":"181","author":"Campbell","year":"1965","journal-title":"J Physiol"},{"issue":"2","key":"bib39","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1111\/j.1475-1313.1987.tb01009.x","article-title":"Effect of target content at higher spatial frequencies on the accuracy of the accommodation response","volume":"7","author":"Tucker","year":"1987","journal-title":"Ophthalmic Physiol Opt"},{"issue":"1","key":"bib40","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1097\/00006324-198601000-00010","article-title":"Depth of focus and accommodation for sinusoidal gratings as a function of luminance","volume":"63","author":"Tucker","year":"1986","journal-title":"Am J Optom Physiol Opt"},{"issue":"10","key":"bib41","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1016\/0042-6989(87)90108-8","article-title":"The effects of optical vergence, contrast, and luminance on the accommodative response to spatially bandpass filtered targets","volume":"27","author":"Kotulak","year":"1987","journal-title":"Vision Res"},{"issue":"3","key":"bib42","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1068\/p110337","article-title":"A demonstration of the visual importance and flexibility of spatial-frequency amplitude and phase","volume":"11","author":"Piotrowski","year":"1982","journal-title":"Perception"},{"issue":"5","key":"bib43","doi-asserted-by":"publisher","first-page":"S504","DOI":"10.3928\/1081-597X-20040901-10","article-title":"The importance of the phase transfer function to visual function and visual quality metrics","volume":"20","author":"Sarver","year":"2004","journal-title":"J Refract Surg"},{"issue":"2","key":"bib44","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1046\/j.1475-1313.1999.00409.x","article-title":"The influence of interactions between accommodation and convergence on the lag of accommodation","volume":"19","author":"Schor","year":"1999","journal-title":"Ophthalmic Physiol Opt"},{"issue":"3","key":"bib45","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1111\/j.1475-1313.1992.tb00403.x","article-title":"Negative feedback control model of proximal convergence and accommodation","volume":"12","author":"Schor","year":"1992","journal-title":"Ophthalmic Physiol Opt"},{"issue":"11","key":"bib46","first-page":"1739","article-title":"Voluntary effort as a stimulus to accommodation and vergence","volume":"29","author":"McLin","year":"1988","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"16","key":"bib47","doi-asserted-by":"publisher","first-page":"14.11","DOI":"10.1167\/8.16.14","article-title":"Cues for the control of ocular accommodation and vergence during postnatal human development","volume":"8","author":"Bharadwaj","year":"2008","journal-title":"J Vis"},{"issue":"15","key":"bib48","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1016\/j.visres.2008.04.023","article-title":"The use of cues to convergence and accommodation in na\u00efve, uninstructed participants","volume":"48","author":"Horwood","year":"2008","journal-title":"Vision Res"},{"issue":"11","key":"bib49","first-page":"791","article-title":"Variations in accommodation and convergence responses in a minimally controlled photorefractive setting","volume":"78","author":"Horwood","year":"2001","journal-title":"Optom Vis Sci"},{"issue":"1","key":"bib50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1364\/JOSAA.23.000001","article-title":"Accommodation with higher-order monochromatic aberrations corrected with adaptive optics","volume":"23","author":"Chen","year":"2006","journal-title":"J Opt Soc Am A Opt Image Sci Vis"},{"issue":"9","key":"bib51","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1364\/JOSAA.22.001732","article-title":"Study on the effects of monochromatic aberrations in the accommodation response by using adaptive optics","volume":"22","author":"Fern\u00e1ndez","year":"2005","journal-title":"J Opt Soc Am A Opt Image Sci Vis"},{"issue":"4","key":"bib52","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1167\/4.4.4","article-title":"Neural compensation for the eye's optical aberrations","volume":"4","author":"Artal","year":"2004","journal-title":"J Vis"},{"issue":"11","key":"bib53","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1167\/iovs.63.11.6","article-title":"Suprathreshold contrast perception is altered by long-term adaptation to habitual optical blur","volume":"63","author":"Ng","year":"2022","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"2","key":"bib54","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1097\/00006324-197802000-00004","article-title":"Accommodation as a function of object form","volume":"55","author":"Charman","year":"1978","journal-title":"Optom Vis Sci"},{"issue":"10","key":"bib55","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1097\/OPX.0000000000000383","article-title":"Changes in the objective amplitude of accommodation with pupil size","volume":"91","author":"Lara","year":"2014","journal-title":"Optom Vis Sci"},{"issue":"3","key":"bib56","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2399\/ana.22.3234287","article-title":"White to white cornea diameter and mesopic pupil size in patients with keratoconus","volume":"16","author":"\u00d6z\u00e7elik","year":"2022","journal-title":"Anatomy"},{"issue":"5","key":"bib57","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1080\/02713683.2016.1242752","article-title":"Pupillary offset in keratoconus and its relationship with clinical and topographical features","volume":"42","author":"Hondur","year":"2017","journal-title":"Curr Eye Res"},{"issue":"2","key":"bib58","doi-asserted-by":"publisher","first-page":"75","DOI":"10.4274\/tjo.galenos.2020.84748","article-title":"The relationship between keratoconus stage and the thickness of the retinal layers","volume":"51","author":"\u00d6zsaygili","year":"2021","journal-title":"Turk J Ophthalmol"},{"issue":"10","key":"bib59","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1055\/a-1743-3067","article-title":"Evaluation of retinal layer thicknesses in patients with keratoconus using retinal layer segmentation analysis","volume":"240","author":"Aydemir","year":"2023","journal-title":"Klin Monbl Augenheilkd"},{"issue":"5","key":"bib60","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1111\/opo.13511","article-title":"Changes in retinal and choroidal thickness and blood density in participants with keratoconus","volume":"45","author":"Sun","year":"2025","journal-title":"Ophthalmic Physiol Opt"},{"issue":"10","key":"bib61","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1364\/JOSAA.25.002395","article-title":"Calculation of retinal image quality for polychromatic light","volume":"25","author":"Ravikumar","year":"2008","journal-title":"J Opt Soc Am A Opt Image Sci Vis"},{"issue":"5","key":"bib62","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1167\/5.5.7","article-title":"The effect of ocular aberrations on steady-state errors of accommodative response","volume":"5","author":"Plainis","year":"2005","journal-title":"J Vis"},{"issue":"4","key":"bib63","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1111\/opo.12075","article-title":"Retinal image quality during accommodation","volume":"33","author":"L\u00f3pez-Gil","year":"2013","journal-title":"Ophthalmic Physiol Opt"},{"issue":"4","key":"bib64","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1111\/opo.12047","article-title":"Modelling the impact of spherical aberration on accommodation","volume":"33","author":"Thibos","year":"2013","journal-title":"Ophthalmic Physiol Opt"},{"key":"bib25","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/0471914878.ch13","article-title":"From wavefronts to refractions","volume-title":"Adaptive Optics for Vision Science: principles, practices, design, and applications","author":"Thibos","year":"2006"}],"container-title":["Investigative Ophthalmology & Visual Science"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/iovs.arvojournals.org\/article.aspx?doi=10.1167\/iovs.67.6.52","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:32:21Z","timestamp":1791927141000},"score":1,"resource":{"primary":{"URL":"http:\/\/iovs.arvojournals.org\/article.aspx?doi=10.1167\/iovs.67.6.52"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":64,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1167\/iovs.67.6.52","relation":{},"ISSN":["1552-5783"],"issn-type":[{"value":"1552-5783","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,26]]}}}