The relationship of choroidal blood flow and accommodation to the control of ocular growth.

We have carried out a number of different studies in chicks to examine the relationship between choroidal blood flow and myopic eye growth, and between accommodation and myopic eye growth. Our studies on choroidal blood flow show that myopic eye growth produced by form vision degradation leads to dramatic reductions in choroidal blood flow. These reductions appear directly attributable to the eye enlargement and the reduction in choroidal blood flow does not appear to be permissive for eye growth, since experimentally reduced choroidal blood flow hinders eye growth. Choroidal blood flow that is slightly above normal, however, may slightly enhance eye growth. Our studies on accommodation do not reveal any major necessary role of accommodation in regulating normal growth or in form vision degradation induced myopic eye growth. We found preliminary evidence, however, that chronically stimulating accommodation over a 2 week period, thereby producing excessive time in accommodation, may be sufficient for yielding a small but significant degree of myopic refractive error. Our studies suggest that neither fluctuations in choroidal blood flow nor an intact accommodative apparatus are essential for normal eye growth or myopic eye growth produced by form deprivation. Further studies are needed to confirm that excessive time in accommodation might be sufficient for producing myopia. Finally, our finding that choroidal blood flow is substantially reduced in myopic eyes may have implications for the etiology of the retinal problems suffered by humans with moderate to severe myopia.