Joseph Trachtman, OD, PhD, believes that many myopes tonically accommodate, resulting in an increase in their myopia (as measured by manifest refraction) and a decrease in uncorrected visual acuity. This tonic accommodation might result either from ciliary spasm from extended close work or from excessive minus sphere in the patient's refractive correction. The result: the patient's uncorrected visual acuity is worse than it would be if their accommodation were relaxed.
To treat this problem, Trachtman has developed the Accommotrac Vision Trainer (Biofeedtrac, Inc., Brooklyn Heights, NY). This device consists of an infrared sensor which measures the refractive state of the eye. The sensor generates an audible tone which provides biofeedback to the patient. During a training session, the patient listens to the tone ana learns to relax his accommodation. Studies show the device is effective at improving uncorrected acuity in myopic individuals who tonically accommodate.
Patients who might benefit include those whose uncorrected acuity is slightly below state standards for driver's licenses or police academy admissions. No claims are made that the device improves the anatomic components of myopia. More importantly, no studies have shown that the Accommotrac performs any better than a properly balanced refraction and temporary cycloplegia.