# High-Order Aberrations: A Key Factor in Accommodative Dysfunctions
## 5 Conclusions  
This study showed the different patterns of changes in ocular aberrations during accommodation and their stability in various accommodative dysfunctions. These findings suggest that these changes may impact the accuracy and stability of the accommodative response. Subjects with different accommodative dysfunctions demonstrated specific patterns of alterations in their optical quality, which may explain their accommodative behaviour. Subjects with EA benefit from having high accommodative responses, as the optical quality increases. In contrast, the absence of changes in subjects with INSA may lead to a lack of cues to control the direction of the accommodative response. Recognizing these patterns may help in understanding the causes of accommodative dysfunctions. Moreover, it can assist in identifying individuals who are at risk of developing accommodative dysfunctions before they show symptoms, potentially enabling earlier intervention and management by eye care professionals. Additionally, those with symptoms but without accommodative dysfunctions previously diagnosed by clinical exams (SWD) show a significant decrease in their ocular optical quality and an increase in their instability, both during and after the accommodative stimuli, which may contribute to the symptoms and may evolve into an accommodative dysfunction.  
These findings offer valuable clinical insights into the connection between accommodative dysfunctions and the optical quality of the eye. Understanding this relationship could help in the early detection of accommodative dysfunctions, even without obvious clinical signs. This knowledge could lead to timely interventions involving personalized visual therapy or optical solutions, aimed at enhancing accommodative control and reducing symptoms.  
It is recommended that future research includes follow-up studies to assess changes in study parameters during visual therapy and their effectiveness in improving accommodative dysfunctions. Additionally, it would be valuable to utilize adaptive optics to manipulate wavefront aberrations and assess their impact on the accommodative response of subjects with accommodative dysfunctions. These studies would offer valuable insights and have implications for future research.  
Conceptualization, S.F.; Methodology, J.G. and S.F.; Validation, S.F.; Formal analysis, J.G.; Investigation, J.G.; Writing--original draft, J.G.; Writing--review & editing, S.F.; Supervision, S.F.; Project administration, S.F. All authors have read and agreed to the published version of the manuscript.  
**Funding:** This research was funded by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UIDB/04650/2020. The author [PERSON] is also supported by the PhD grant 2020.08737.BD from FCT.  
**Institutional Review Board Statement:** The study adhered to the tenets of the Declaration of Helsinki and was approved by the Ethical Subcommittee of Life and Health Sciences of the University of Minho (SECVS 029/2014 (ADENDDA), 2 July 2019.  
**Informed Consent Statement:** All subjects signed an informed consent form with an explanation of the procedures.  
**Data Availability Statement:** The raw data supporting the conclusions of this article will be made available by the authors on request.  
**Conflicts of Interest:** There are no conflicts of interest to declare.