Compared with spectacles, do myopes accommodate more or less with contact lenses?

• A. More
• B. Less
• C. About the same
• D. Not at all

Answer: (A)

Accommodation demand is influenced by where the corrective lens sits relative to the eye. When correction is done with spectacles, the lens is a short distance in front of the eye, so part of the near focusing requirements can be offset by the light’s path through the spectacle lens before it reaches the eye. With contact lenses, the correction sits directly on the cornea, so the eye has to supply the entire near focusing power itself to bring the image into focus. For myopes, this means the eye ends up doing more of the accommodative work for near tasks when wearing contact lenses than when wearing spectacles. In practice, the difference is usually modest and depends on viewing distance and lens powers, but the basic idea is that the nearer, in-contact correction places a larger accommodative load on the eye for near targets.