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Showing papers on "Accommodation published in 2021"


Journal ArticleDOI
TL;DR: In this article, the authors investigated how COVID-19 is impacting different accommodation types, and whether travellers' choices regarding accommodation type are affected by the need for physical distance, and they found that full flats are preferred to hotel rooms.

77 citations


Journal ArticleDOI
TL;DR: In this article, the authors explored the decision-making attributes driving tourists' accommodation purchasing preferences in times of increased uncertainty using fuzzy-set Qualitative Comparative Analysis and evaluated the size effect of the examined conditions using Necessary Condition Analysis.

75 citations


Journal ArticleDOI
TL;DR: The International Myopia Institute white paper as mentioned in this paper reviewed the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression and provided recommendations for targeted interventions to slow myopia progression.
Abstract: The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.

27 citations


Journal ArticleDOI
TL;DR: In this paper, the authors formulate the most probable future scenario for the accommodation sharing sector within the next five to ten years and identify the most likely holistic future scenario by conducting a two-stage Delphi study involving 59 expert panelists.
Abstract: This paper aims to formulate the most probable future scenario for the accommodation sharing sector within the next five to ten years. It addresses the following six thematic aspects: relevance, different forms of accommodation sharing, users, hosts, platforms, and finally, industry regulation.,This study identifies the most likely holistic future scenario by conducting a two-stage Delphi study involving 59 expert panelists. It addresses 33 projections for six thematic sections of the accommodation sharing industry: relevance, different forms of accommodation sharing, users, hosts, platforms, and finally, industry regulation.,The results indicate that the number of shared accommodations and users of home-sharing will increase. Moreover, the cost advantage is the predominant driver for users to engage in the accommodation sharing segment, and for the hosts, the generation of an extra income is the primary incentive. Finally, the regulation within this industry is expected to be more effective in the foreseeable future.,The results are critical, not only to advance our theoretical understanding and stimulate critical discussions on the long-term development of accommodation sharing but also to assist governments and policymakers who have an interest in developing and regulating this sector and developers seeking business opportunities.,While there is ample knowledge about the past and current development of accommodation sharing in tourism, little is understood about its potential future development and implications for consumers, the economy, and society. To date, no scientific research is available that develops scenarios about the future of accommodation sharing.

16 citations


Journal ArticleDOI
TL;DR: In this paper, the authors examine the evolution of the institutional logic of public finance in Brazil, adopting both an historical time frame and a short time frame of recent reforms, and find that a bureaucratic logic of budgeting at the level of the organizational field has blended historically with a political logic of patrimonial power at the societal level to form a succession of hybrid institutions.
Abstract: This paper examines the evolution of the institutional logic of public finance in Brazil, adopting both an historical time frame and a short time frame of recent reforms. We find that a bureaucratic logic of budgeting at the level of the organizational field has blended historically with a political logic of patrimonial power at the societal level to form a succession of hybrid institutions. Adopting a shorter-term perspective, we observe the processes by which hybridization occurs in response to reforms for fiscal responsibility and accruals reporting. Our analysis reveals two pathways to hybridization: by the assimilation of compatible institutional logics and by the accommodation of contradictory logics. We explain reform outcomes as the product of the agency of actors performing social roles across the organizational field. These generate a ‘package’ in which the accommodation of change in some respects is facilitated by the persistence of operational routines in other respects. In reviewing our contribution, we propose that more attention should be given to studies at the level of the organizational field which reveal agency as the product of the structural position of role-holders to complement studies of specific organizations which tend to suggest strategic agency.

15 citations



Journal ArticleDOI
TL;DR: In this paper, the authors explored the acceptability of offering accommodation to support self-isolation among at risk populations, to prevent transmission of Covid-19 within vulnerable households.
Abstract: Within-household transmission of Covid-19 is responsible for a significant number of infections. Efforts to protect at risk communities are needed. This study explored the acceptability of offering accommodation to support self-isolation among at risk populations, to prevent transmission of Covid-19 within vulnerable households. Mixed methods design structured in two phases. Phase 1: Survey of 545 individuals who had provided consent to be contacted about ongoing research projects into infection control. Phase 2: Semi-structured interviews with 19 participants from ethnic minority and low income communities. Many survey and interview participants viewed the provision of accommodation as important and necessary in certain contexts. Of the 110 survey respondents, 85 (77%) said that they were not able to isolate at home. Among this group, 24 (28%) said they would accept accommodation and 23 (27%) said that they would probably accept. Of those unable to isolate at home, and at high risk if they caught the virus (N = 36) or living with someone at high risk (N 18), 19 (35%) said that they would accept, and 12 (22%) said they would probably accept accommodation. Factors influencing uptake of accommodation included perceived 1) household vulnerability 2) virus exposure and 3) lack of isolation at home options. Barriers to accepting the accommodation offer included 1) able to isolate at home 2) wanting to be with family 3) caring responsibilities 4) mental wellbeing concerns 5) concerns about moving when ill and 6) infection control concerns. Participants raised issues that should be addressed before accommodation is offered, including questions regarding who should use temporary accommodation and when, and how infection control in temporary accommodation would be managed. The provision of accommodation to prevent within household transmission of Covid-19 is viewed as acceptable, feasible and necessary by some people who are concerned about infection transmission in the home and are unable to self-isolate or socially distance at home. Different households will have different requirements, e.g., those with caring responsibilities, and to overcome these challenges additional support may be needed for the provision of accommodation to be feasible to those who could benefit most.

13 citations


Journal ArticleDOI
TL;DR: In this article, the authors used objective and subjective measures simultaneously to determine where the human eye is best focused, and the objective measures were made with a wavefront sensor and an autorefractor, both of which analyzed light reflected from the retina.
Abstract: The focusing response of the human eye - accommodation - exhibits errors known as lags and leads. Lags occur when the stimulus is near and the eye appears to focus farther than the stimulus. Leads occur with far stimuli where the eye appears to focus nearer than the stimulus. We used objective and subjective measures simultaneously to determine where the eye is best focused. The objective measures were made with a wavefront sensor and an autorefractor, both of which analyze light reflected from the retina. These measures exhibited typical accommodative errors, mostly lags. The subjective measure was visual acuity, which of course depends not only on the eye's optics but also on photoreception and neural processing of the retinal image. The subjective measure revealed much smaller errors. Acuity was maximized at or very close to the distance of the accommodative stimulus. Thus, accommodation is accurate in terms of maximizing visual performance.

11 citations


Journal ArticleDOI
TL;DR: This research aims to find out the emerging architect's design methods in Bali in designing tourist accommodation using in-depth interview technique and design document study with research variables, then analyzed through theories based on predetermined variables.
Abstract: Design as an activity involves certain ways and paths that must be traversed to achieve the goal. But along with the involvement of new architects in the realistic architectural world, whether it contributes to the introduction of new design approaches, influencing the direction taken to achieve design goals, the current architect in his work is the right research object to study it. The background of the knowledge makes the architect certainly form thought about their way or method of design. This research aims to find out the emerging architect's design methods in Bali in designing tourist accommodation. The benefits of the study can be used as teaching materials for students to build tourist accommodation and provide tourism actors with information about aspects that need to be considered in the design of tourist accommodation. This research's qualitative method, with in-depth interview technique and design document study with research variables, then analyzed through theories based on predetermined variables. The results of data analysis are described qualitatively to get a conclusion. The results showed two design processes (intuitive way and rational way) passed by architects in designing tourist accommodation. The design factors that are the main generator of problems in designing and design solutions are also developed differently, depending on the context and type of tourist accommodation.

11 citations


Journal ArticleDOI
TL;DR: In this article, a new perspective on peer-to-peer (P2P) accommodation concerns economic transactions that involve people's private territory, and the authors emphasize the territorial aspect of P2P accommodation.
Abstract: Peer-to-peer (P2P) accommodation concerns economic transactions that involve people’s private territory. To provide a fresh perspective on P2P accommodation, this article emphasizes the territorial...

10 citations



Journal ArticleDOI
TL;DR: Despite the progressive introduction of accommodation taxes in many European cities, there is no consensus in the literature as to whether they have positive or negative effects as mentioned in this paper. This may be relate...
Abstract: Despite the progressive introduction of accommodation taxes in many European cities, there is no consensus in the literature as to whether they have positive or negative effects. This may be relate...

Journal ArticleDOI
TL;DR: It is common for students to withdraw physically and psychologically when they do not form friendships within their flat, and accommodation-based pastoral staff have an important role to fulfil, demonstrating the importance of the human element within accommodation.
Abstract: Due to the increasing concern over student mental health and wellbeing, attention has turned to the matter of creating environments, communities, and institutions which enable students to flourish. To explore the role of accommodation environments in first year student mental health and wellbeing, eight focus groups were conducted in two universities in North West England and analysed using thematic analysis. Three overarching themes were identified: ‘The betwixt space’; ‘Accommodations as vessels to cultivate friendships and communities’; and ‘The importance of accommodation-based pastoral staff’. As attachment to place and relationships with significant others are disrupted by the transition, this leaves young people vulnerable whilst they go through a process to re-attach to new people and a new environment, and loneliness and social isolation were keenly felt during this period. Physical attributes of place that prevent social cohesion further exacerbated feelings of loneliness. As it is common for students to withdraw physically and psychologically when they do not form friendships within their flat, accommodation-based pastoral staff have an important role to fulfil. Although these findings demonstrate the importance of the human element within accommodation, designing places that facilitate community, a sense of we-ness, and belonging is crucial.

Journal ArticleDOI
Song Yutong1, Zhu Shenlin1, Bi Yang1, Xue Wang1, Wei Ma1, Guangjing Dong1, Longqian Liu1 
TL;DR: In this article, the authors observed and analyzed the dynamic accommodation and binocular vision changes in myopic children after they switched from spectacles to orthokeratology (ortho-k) lenses.
Abstract: The study aimed to observe and analyze the dynamic accommodation and binocular vision changes in myopic children after they switched from spectacles to orthokeratology (ortho-k) lenses. Thirty-six myopic children aged 8-14 years were enrolled in this prospective, self-controlled study from West China Hospital. General information was gathered, and examinations were performed at baseline and at 1, 3, 6, and 12 months after switching to ortho-k lenses. The examination included assessments of distance/near visual acuity, distance/near horizontal and vertical ocular alignment, distance/near horizontal vergence range, accommodative amplitude, monocular/binocular accommodative facility, accommodative response, positive and negative relative accommodation (PRA/NRA), accommodation convergence/accommodation (AC/A), stereopsis, and reading ability. After the children switched to ortho-k lenses, distance and near ocular alignment showed an exophoric shift (distance: p = 0.001, near: p = 0.002), and the horizontal vergence range decreased by different degrees (convergence: distance blur point (p = 0.002), distance break point (p = 0.005), near blur point (p = 0.011), near break point (p = 0.043); divergence: distance break point (p < 0.001), distance recover point (p < 0.001), near recover point (p = 0.005)). The stereopsis ability (p < 0.001), monocular/binocular accommodative facility (p < 0.001), and PRA (p = 0.010) increased. The accommodative lag (p < 0.001), accommodative amplitude (p < 0.001), and calculated and gradient AC/A (calculated: p = 0.001, gradient: p = 0.025) decreased. The adjusted horizontal and vertical reading times and their ratio decreased (all p < 0.001). The subjects showed distance and near exophoric shifts after switching to ortho-k lenses; improvements in accommodative function, stereopsis, and ocular motility; and a decrease in the binocular horizontal vergence range. The relationships between these changes and the ortho-k myopic control effects require further investigation.

Journal ArticleDOI
TL;DR: In this article, the role of Emotional Intelligence (EI) and Emotional Dissonance (ED) in employee-customer relations in the context of Environmental Stimuli (ES) in the tourism accommodation sector has remained unexplored.
Abstract: While scholarly inquiries into Service Sabotage (SS) have received ample attention in the literature of various industries, the role of Emotional Intelligence (EI) and Emotional Dissonance (ED) in employee-customer relations in the context of Environmental Stimuli (ES) in the tourism accommodation sector has remained unexplored. The role of employee–customer interaction in tourism is paramount for a hospitality organization’s growth, sustainability, and profitability. We hypothesized hotel service employees’ EI and ED can be influential factors to SS. Adopting the Mehrabian–Russell model (M–R) and Stimulus-Organism-Response (S-O-R) framework as conceptual paradigms, we tested the effect of hotel ambiance on employees’ emotions, which can have significant effects on SS. The study revealed that ES links to behaviors and elicits EI and ED as human emotional responses to environments that have a parallel mediating effect on mitigating or neutralizing the negative effect of SS in an organization. The findings provide important insights into an organization’s awareness of the provision of ES as a positive factor for employees, subsequently forming their behavioral consequences of EI and ED which can mitigate the negative impacts of SS. The study yields important implications on how hospitality organizations should pay attention to the impact of rule-breaking behaviors. Theoretical and practical implications are also discussed.

Journal ArticleDOI
TL;DR: In this paper, the authors examined the concurrent impact of weather and the COVID-19 disaster on post-disaster camping trip plans among leisure travelers in the 48 contiguous United States.


Journal ArticleDOI
01 Jan 2021
TL;DR: In this paper, the authors investigated the platform-mediated tourism practices by focusing on the new recreational activities offered by Airbnb, namely "Experiences" and found that these activities seem to erode the well-known spatial concentration of accommodation listings in city centres.
Abstract: The article investigates platform-mediated tourism practices by focusing on the new recreational activities offered by Airbnb, namely “Experiences”. In recent years, the leading short-term rental platform has started an expansion strategy beyond accommodation towards services based on immersive activities led by local hosts. Drawing upon previous research on short-term accommodation platforms, we explore the platformization of such recreational activities by looking at their spatialities, the place-based resources engaged and emerging self-entrepreneurial practices. Our effort is experimental since most literature on Airbnb deals with accommodation listings while Experiences differ from accommodation since they combine different types of local resources, which are less spatially constrained, with the host's personal skills. This paper contributes to understanding the spatial and socio-economic implications of the Airbnb expansion strategy through Experiences. We develop a case study based on 385 Experiences collected in Florence (Italy) in 2019 and analyze their location and distribution patterns, the estimated revenue generated, the typology of resources which are commodified through such activities, and the professional profiles of the hosts. Results show that Experiences seem to erode the well-known spatial concentration of accommodation listings in city centres. This is explained by the different nature of the resources mobilized by the Experiences, which privilege the experiential character of these services (e.g. food tasting, cooking classes). Furthermore, Experiences become a self-employment opportunity for the hosts, reinforcing the unregulated and permeable environment of the digital platform.

Journal ArticleDOI
TL;DR: In this paper, the authors have addressed the issue of platform economy in the context of accommodation, focusing mainly on Airbnb and large cities, but they have mainly focussed on large cities.
Abstract: Accommodation is one of the main sectors affected by the emergence of platform economies. This issue has been addressed by many researchers, but they have mainly focussed on Airbnb and large cities...

Journal ArticleDOI
TL;DR: The dynamics of the accommodative response as a function of the subject's refractive error is studied as a first step in determining whether an anomalous accommodative function could affect emmetropization or trigger myopia progression.
Abstract: The purpose of this work is to study the dynamics of the accommodative response as a function of the subject's refractive error, as a first step in determining whether an anomalous accommodative function could affect emmetropization or trigger myopia progression. A secondary goal was to establish potential relationships between the speed of accommodation and other parameters in the accommodation process. Parameters related to the speed and amplitude of accommodation, convergence, miosis, and change in high-order aberrations were measured during the accommodative process for 2.8 D demand in 18 young healthy subjects (mean age 25.0 ± 4.7 years) with a range of refractive errors between 0 and -7.5 D (spherical equivalent). Measurements were performed in real time (25 Hz) with an open-view binocular Hartmann-Shack (HS) sensor using a GPU-based processing unit. Correlation coefficients were calculated between refractive error and each computed variable. Additionally, the speed of accommodation was correlated with all the other parameters in the study. Correlation coefficients with refractive error had non-zero values for several parameters of the accommodative response but p-values were higher than 0.05 except in two cases: with pupil miosis speed (R = –0.49, p = 0.041) and with lag of accommodation (R = –0.57, p = 0.014). Additionally, correlation values with p-value < 0.05 were found between accommodation speed and convergence duration (R = 0.57, p = 0.014), convergence speed (R = 0.48, p = 0.044), and pupil miosis amplitude (R = 0.47, p = 0.049). We did not find strong evidence of a link between myopia and altered dynamics of the accommodation process. Only miosis speed was found to be correlated to refractive error with p < 0.05, being slower for myopes. On the other hand, increased lag of accommodation tends to be associated to larger refractive errors. Additionally, our data suggests that the faster the accommodation, the faster and longer the convergence and the larger the pupil miosis.

Journal ArticleDOI
TL;DR: In Britain, the number of young single people living in shared accommodation is on the rise as discussed by the authors and while sharing may be positive when voluntarily chosen, those who are forced to share accommodation may h...
Abstract: In Britain, the number of young single people living in shared accommodation is on the rise. While sharing may be positive when voluntarily chosen, those who are forced to share accommodation may h...

Journal ArticleDOI
TL;DR: This article measured ocular HOA's in ninety non-myopic, school-aged children during short-term accommodation tasks at 0, 3, 6, and 9 D demands presented via a Badal optometer mounted to a Hartmann-Shack wavefront aberrometer.

Journal ArticleDOI
TL;DR: In this article, the authors approach the process of opening accommodation centres from the perspective of mayors in rural municipalities, where the allocation and accommodation of refugees is a competence of local authorities.
Abstract: This article approaches the process of opening accommodation centres from the perspective of mayors in rural municipalities. Although the allocation and accommodation of refugees is a competence of...

Journal ArticleDOI
TL;DR: In this paper, the authors argue that the Spanish asylum reception system is characterized by a hybrid model that imposes forms of discipline and neglect, and analyze the implications of this hybrid model in terms of asylum seekers trajectories and eventual inclusion.
Abstract: In 2019, Spain had the third highest number of asylum applications in the Europen Union, after Germany and France. The number of asylum applications grew from 31,120 in 2017 to 55,668 in 2018 and 118,264 in 2019. Following this exponential increase, the number of accommodation places in the state reception system has risen almost proportionally. In this changing context, this article seeks to explain the regulation of asylum accommodation in Spain. Following critical refugee studies in the Global North and the Global South, we argue that the Spanish asylum reception system is characterized by a hybrid model that imposes forms of discipline and neglect. By using a mixed-methods approach combining document analysis of secondary data, in-depth interviews with both stakeholders and asylum seekers, and an exploratory survey to 301 asylum seekers, we analyse the implications of this hybrid model in terms of asylum seekers trajectories and eventual inclusion.

Journal ArticleDOI
TL;DR: Investigating how accommodation environments influence students' mental health with a focus on the concept of relational spaces found a low sense of belonging and feeling uncomfortable were associated with higher levels of depression, anxiety, and loneliness.
Abstract: Despite Universities UK emphasising a “whole university approach” to improve mental health and wellbeing, quantitative research exploring the role of accommodation environments in student mental he...

Journal ArticleDOI
TL;DR: In this paper, the authors examined the inequality level measured by the Gini coefficient in 108 municipalities of the peripheral region of northeastern Poland from 2009 to 2018, and employed a directional spillover index to measure the impact of two accommodation types on tax incomes per capita.
Abstract: Regional inequalities are a major concern for governments and policymakers. There is no doubt that tourism impacts the reduction of inequalities, but this impact is not entirely clear. We consider this ambiguity to be related to both the level of study and type of accommodation. In the present study, we examine the inequality level measured by the Gini coefficient in 108 municipalities of the peripheral region of northeastern Poland from 2009 to 2018. We employ a directional spillover index to measure the impact of two accommodation types on tax incomes per capita. The empirical results indicate that collective accommodation-based tourism only reduced inequality during the financial crisis, while individual accommodation-based tourism started to reduce inequality from 2014, when Russian sanctions hit local agriculture and businesses. These results indicate that the role of accommodation types is time-varying and evident in measuring economic distress during and after shocks.

Journal ArticleDOI
09 Feb 2021
TL;DR: In this article, the authors verify the hypothesis that seasonality in the peer-to-peer market for tourist accommodation is smaller than the existing in conventional markets, taking the case of the island of Majorca as a reference.
Abstract: The purpose of this paper is to verify the hypothesis that seasonality in the peer-to-peer (p2p) market for tourist accommodation is smaller than the existing in conventional markets, taking the case of the island of Majorca as a reference. This paper will also determine the role of professional hosts in the management of prices and in the marketing of accommodation according to seasonal demand variations.,From the information obtained through web scrapings of Airbnb listings and from data provided by official statistics, comparable indicators of seasonality are developed. Likewise, econometric estimates are provided to detect differences regarding the determination of accommodation prices between professional and nonprofessional hosts.,The p2p market is less subject to seasonality than the conventional one. In the particular case of Palma de Majorca, fluctuations in accommodation demand are even smaller than in the rest of the island's municipalities. Professional hosts apply marketing techniques related to price and product promotion and are sensitive to demand variations altering prices and responding to the economic stimuli in this way. At an academic level, these findings suggest, on the one hand, the relevance of considering the heterogeneity of the touristic market when constructing theoretical models. And, on the other hand, basic economic principles should be applied to explain agent behavior in the p2p market.,This work does not use a direct demand measurement. Instead, it approximates demand through the reviews left by guests in p2p markets. At least in the case of the island of Majorca, the touristic demand represents a reduced percentage of touristic demand in total.,So far, both public and private strategies to combat seasonality have focused on increasing occupancy in conventional accommodation. Still, the fact that hotel demand and private accommodation demand are different has relevant implications for price management, touristic products, supply planning and the implementation of marketing campaigns. Also, advertising could be aimed at alleviating the undesirable effects of seasonality.,The evidence presented helps the design of public policy strategies aimed at mitigating the problem of seasonality in touristic demand to accommodate it to social preferences in each area.,This is the first piece of research, as far as we are aware of, that addresses the phenomenon of demand seasonality in the p2p market for tourist accommodation. In addition, a comparison is made with the seasonal patterns that characterize the conventional hotel market. New ideas are provided for the design of a comprehensive touristic policy in which both markets are considered.

Journal ArticleDOI
TL;DR: In this paper, the authors used fuzzy analytic hierarchy process (FAHP) and geographic information system (GIS) techniques to support the decision-making of tourists for choosing the optimal accommodation by combining FAHP and GIS techniques.
Abstract: Finding the place of accommodation is one of the most crucial issues during a journey. This study aims to support the decision-making of tourists for choosing the optimal accommodation by combining fuzzy analytic hierarchy process (FAHP) and geographic information system (GIS) techniques. The adopted criteria are the cost per room, the distance from the center, the level of security, the place rating, and the availability of free cancellation and breakfast. Due to some uncertainty and diversity of criteria, the FAHP approach is applied to consolidate tourists’ decisions by applying criteria weighting, while the GIS is used to overlay the weighted criteria and to visualize the ranked places of accommodation on a map. The combined technique is applied on a case study in Budapest City, where the analysis is conducted on 364 places of accommodation. The results show that half of the places are recommended for tourists, and more than fifth of the accommodations are highly recommended. Furthermore, it can be concluded that the cost per room was the highest influential criterion with 0.233 importance weight, followed by the security level with 0.205. The lowest factor affecting the choice of accommodation was the free cancellation service. It was demonstrated that the rating weight importance was 0.182, while the breakfast and the distance from the center had approximately the same importance. As a recommendation, some improvements on the accommodation, such as decreasing the cost per room, enhancing the services, or developing the quality of the places, would increase their attractiveness for tourists.

Journal ArticleDOI
TL;DR: In this article, a consumer focus was adopted in examining the impact of perceived legitimacy of sharing economy platforms on attitude and behavioural intention in the accommodation sector, by investigating the relationship between perceived legitimacy and attitude and behavioral intention.
Abstract: This research adopts a consumer focus in examining the impact of perceived legitimacy of sharing economy platforms on attitude and behavioural intention in the accommodation sector. By investigatin...

Journal ArticleDOI
TL;DR: The authors reported a case of unusual pseudomyopia with paradoxical accommodation, straining eyes to induce emmetropia at far distance and relaxing eyes to focus at near objects, contrary to physiological accommodation.
Abstract: Pseudomyopia is caused by increased refractive power by ciliary muscle spasm Most patients cannot overcome pseudomyopia spontaneously; therefore, treatment of pseudomyopia is fastidious and needs a multidisciplinary approach We report a case of unusual pseudomyopia with paradoxical accommodation, straining eyes to induce emmetropia at far distance and relaxing eyes to focus at near objects, contrary to physiological accommodation A 33-year-old woman experienced intermittent distant vision discomfort This occurred at least a few hundred times daily She could see near objects clearly; however, distant objects could be seen clearly only when she strained her eyes Uncorrected distance visual acuity was 20/20 and manifest refraction (MR) in both eyes in the relaxed state was approximately − 25 D MR changed to approximately − 05 D when she grimaced and strained her eyes when attempting to focus on distant letters Her response was contrary to the physiological accommodative response Cycloplegic refraction was approximately 00 D Binocular autorefractor/keratometer was used to objectively evaluate her refractive response and pupil reaction according to accommodative stimulation The IOL Master was used to evaluate the anterior chamber depth (ACD), lens thickness (LT), and pupil diameter with relaxed and strained eyes For stepwise static accommodative stimuli (1–5 D), the refractive responses were correspondingly stepwise, similar to those elicited by healthy individuals However, contrary to physiological accommodation, she strained her eyes to see distant objects and relaxed them to see near objects There was no change in pupil diameter despite the accommodative stimuli being maximum Biometry results showed that ACD deepened and LT flattened with eye strain, which were contrary to those during physiological accommodation We report a rare case with reverse of physiological accommodative response When patients complain of unusual distant visual discomfort, pseudomyopia with paradoxical accommodation should be considered