Assessment of accommodative function in individuals aged 40–50 years with stage 1 hypertension without hypertensive retinopathy compared with age-matched healthy controls

Purpose To compare accommodative function between middle-aged adults with stage 1 hypertension and age-matched healthy controls and to investigate the association between blood pressure and accommodative parameters.Methods This cross-sectional analytical study included 63 participants aged 40–50 years, comprising 33 patients with stage 1 hypertension without hypertensive retinopathy and 30 healthy controls. All participants underwent standardized systemic and ophthalmic examinations. Accommodative function was evaluated using accommodative amplitude (AA), monocular accommodative facility (MAF), accommodative response assessed by monocular estimation method retinoscopy (MEM), positive relative accommodation (PRA), and negative relative accommodation (NRA).Results A total of 63 participants were included. MAF and PRA were significantly lower in the hypertension group than in the control group (both p < .05). No significant between-group differences were observed in AA, accommodative response (MEM), or NRA (all p > .05). Diastolic blood pressure was positively correlated with accommodative response (r = 0.356, p = .042). In multiple linear regression analysis, hypertension was independently associated with MAF (β = −1.936, p = .001) and PRA (β = 0.259, p = .002).Conclusions Patients with stage 1 hypertension without hypertensive retinopathy showed reduced MAF and PRA despite preserved AA. These findings suggest that dynamic accommodative function may be affected early in hypertension, before clinically detectable ocular complications develop.