Effect of surround propinquity on the open-loop accommodative response.

The effect of knowledge of surround propinquity, ie, awareness of proximity of the adjacent surroundings, on the open-loop accommodative response (AR) was determined by comparing measurements of accommodation obtained in total darkness in two different-sized rooms. The AR was measured in two laboratories, one 2.5-m square and the other 6.75 x 2.75 m. Steady-state accommodation was assessed on two occasions in each room using an infrared optometer. On the first occasion, the subjects (n = 10) were fully aware of the laboratory dimensions and topography. For the second trial, they were blind-folded before entering the laboratory and hence were unaware of the experimental location. When subjects were unaware of the laboratory dimensions, no significant difference existed between the recorded values of AR. However, when subjects were initially able to observe the size of the room, the AR in darkness was significantly higher in the smaller laboratory. This suggests that proximally induced accommodation, initiated by prior knowledge of the dimensions of the laboratory, was responsible for this increase in AR. Furthermore, it is proposed that complex interactions exist between proximal, tonic, and other nonoptical accommodative stimuli such that it may be impossible to isolate an individual, nonoptical accommodative component.

The linearity of proximally induced accommodation and vergence.

This study sought to determine the linearity and amplitude of both proximally induced accommodation (PIA) and vergence (PIV) by comparing the open-loop accommodation and vergence responses, respectively, to individual stimuli located at viewing distances ranging from 0.20 m to 1,500 m. For the measurement of PIA, the vergence and accommodation loops were opened by subjects (N = 10) monocularly viewing the target through a 0.5-mm pinhole, while accommodation was assessed concurrently using an infrared optometer. In the assessment of PIV, the accommodation loop was opened either by subjects (N = 10) viewing a low-frequency difference of Gaussian (DOG) grating or by viewing the targets binocularly through 0.5-mm pinholes. For both PIV methods, the vergence loop was opened by vertical dissociating prisms while the heterophoria was assessed for the various target distances using the von Graefe technique. The results demonstrated significant changes in both PIA and PIV for stimuli located closer than 3 m. However, both proximal components attained a minimum level and remained constant for targets at or beyond 3 m. Furthermore, the magnitudes of PIA and PIV were linearly related to the target distance measured in diopters and meter angles, respectively. These findings clearly demonstrate the influence of target proximity on the oculomotor system.

Proximally induced accommodation and accommodative adaptation.

To determine the effect of proximally induced accommodation (PIA) on accommodative adaptation, this study has examined the posttask shift in tonic accommodation (TA) following 5-min monocular viewing of equivalent-sized targets located at distances of 0.33 and 5 m. The distal target was viewed through a negative lens to equate the dioptric stimuli (3 D). The steady-state accommodative response was measured subjectively in 10 subjects using a Hartinger coincidence optometer. A significant correlation was observed between the degree of adaptation following the two conditions, with the magnitude of adaptation for the distal target being approximately half that for the nearer target. Furthermore, adaptation magnitude was inversely correlated with pretask TA under both conditions. These results indicate that PIA can produce accommodative adaptation. The implications of this finding are discussed with regard to models of the accommodative mechanism.

Connections to cerebellar cortex (Larsell's HVI) in the rabbit: a WGA-HRP study with implications for classical eyeblink conditioning.

Conditioned eyeblink responses are presumably learned in the cerebellum and relayed to motoneurons by way of the red nucleus. Projections from the red nucleus to cerebellar cortex (Larsell's lobule HVI) could be important for shaping temporally adaptive features of the conditioned response. Rabbits that had pipettes containing wheat germ agglutinated horseradish peroxidase (WGA-HRP) implanted unilaterally into HVI showed retrograde labeling of neurons within subregions of the contralateral red nucleus implicated in eyeblink conditioning by lesioning and recording studies. Retrogradely labeled neurons were also observed in the pontine nuclei, inferior olive, and spinal trigeminal nucleus pars oralis. Projections to HVI provide a possible neural substrate for implementing time-derivative computational models of learning in the cerebellum. Time-derivative models are capable of describing the timing and topography of conditioned responses.

Red nucleus lesions impair acquisition of the classically conditioned nictitating membrane response but not eye-to-eye savings or unconditioned response amplitude.

Following a single electrocoagulating RF lesion aimed at left red nucleus, rabbits received classical conditioning of the nictitating membrane (NM) response. A tone was the conditioned stimulus (CS) and electrostimulation of the eye was the unconditioned stimulus (US). The US was applied to the right eye during the initial phase of training. It was then switched to the left eye to assess transfer of learning and ultimately switched back to the right eye. NM responses were recorded simultaneously from both eyes during each phase of training. Consistent with reports implicating a cerebellar-rubro circuit in this behavior, RN lesions disrupted acquisition of CRs in the eye contralateral to the lesion. Animals with disrupted NM CRs of the right eye resembled controls in showing transfer of conditioning to the left eye. CR-disrupting lesions did not affect UR amplitude.

Red nucleus lesions disrupt the classically conditioned nictitating membrane response in rabbits.

Sixteen rabbits received classical conditioning of the right nictitating membrane response using a tone CS and electrostimulation of the right eye as the US. Single electrocoagulating RF lesions of the medial portion of the left magnocellular red nucleus eliminated or severely reduced the previously acquired conditioned response. This finding is consistent with the idea that an essential anatomical substrate of the conditioned response includes a circuit from the cerebellum to the contralateral red nucleus which projects contralaterally in turn to pontine motoneurons mediating the defensive nictitating membrane response.

An HRP study of the brainstem afferents to the accessory abducens region and dorsolateral pons in rabbit: implications for the conditioned nictitating membrane response.

Brain projections to the accessory abducens region and dorsolateral pons were investigated in rabbit using implants of crystalline horseradish peroxidase (HRP). Following implantation of HRP in the accessory abducens region (N = 3), labeled cells were observed in the sensory trigeminal nuclei and other regions implicated in the reflex pathway of the defensive nictitating membrane (NM) response. Neurons in the supratrigeminal zone were also labeled, as were portions of the contralateral red nucleus. Implantation of HRP into the dorsolateral pons (N = 5) revealed ipsilateral projections from deep-cerebellar nuclei in some cases. In addition, the parvocellular reticular formation displayed bilateral labeling of cells and an ipsilateral network of fibers and apparent terminations. Many cells of the contralateral supratrigeminal zone were labeled in these cases. Results were discussed in relation to lesioning and electrophysiological studies implicating the supratrigeminal region and other structures in the control of the classically conditioned NM response. Specifically, the possibility that supratrigeminal neurons are premotor elements responsible for the conditioned response is considered. Alternative hypotheses are discussed, including pathways by which cerebellar nuclei could control conditioned responding.

Brachium conjuntivum and rubrobulbar tract: brain stem projections of red nucleus essential for the conditioned nictitating membrane response.

The trajectory of the rubrobulbar tract in rabbit to the level of the accessory abducens nucleus is described: orthograde labeling of fibers of the rubrobulbar tract following horseradish peroxidase implants into red nucleus of 8 animals permitted ad hoc analysis of the effects of brain stem lesions on the rabbit's conditioned nictitating membrane response. Twenty-four rabbits, trained to give conditioned NM responses from both eyes, received unilateral lesions of the right pontine brain stem. Six of the 7 cases of post-lesion disruption of ipsilateral conditioned responding involved either ipsilateral brachium conjunctivum or the rubrobulbar tract. This finding, together with a reexamination of data from two related studies from this laboratory strongly support the conclusion that an essential premotor component of the conditioned NM response is a doubly decussating circuit from the interpositus nucleus of the cerebellum to magnocellular red nucleus, via brachium conjunctivum and its decussation, and from red nucleus caudally, via the ventral tegmental bundle and the rubrobulbar tract, to the accessory abducens nucleus, where motoneurons involved in the NM response are located. These findings are consistent with published reports on the essential role of interpositus nucleus of the cerebellum in NM conditioning. The possible role of the supratrigeminal reticular formation in this learned behavior is also discussed.

The influence of alpha-adrenergic agents on tonic accommodation.

This study has examined the effect of an alpha-1 adrenergic agonist (phenylephrine HCl, 2.5%) and a non-selective alpha antagonist (thymoxamine HCl, 0.5%) on tonic accommodation (TA). TA was measured at 1 min intervals throughout a 45 min period using an objective infra-red optometer (Canon Autoref R-1). Additionally pupil diameter and the near-point of accommodation (NPA) were monitored in order to assess the efficacy of the instilled drug. A double-blind protocol was adopted between thymoxamine, phenylephrine and a saline control for 7 emmetropic subjects. There was no significant difference between the values of TA obtained under the three pharmacological conditions. However, both adrenergic agents induced changes in pupil diameter and NPA. Furthermore in all conditions TA increased by approximately 0.25D while the subject sat passively in darkness. The data indicates that alpha-adrenergic innervation alters the closed-loop accommodative response independently of TA.

Vergence adaptation in children and its clinical significance.

BACKGROUND AND PURPOSE: Vergence adaptation has not been well investigated in children even though it may contribute to binocular dysfunction and near work induced asthenopia. METHODS: We compared vergence adaptation in 18 children and 18 young adult subjects by assessing tonic vergence (TV) before and immediately after a period of sustained near fixation, by measuring heterophoria with a synoptophore through 0.5 mm binocular pinholes. Adaptation was induced by a reading task at 15 cm for a continuous 5 minute period. RESULTS: Mean pre-task TV values of 0.70 MA (Meter Angles) and 0.20 MA were observed for the children and young adults, respectively (p = 0.08). The initial mean vergence adaptation for children and adults was +0.45 MA and +0.11 MA, respectively (p = 0.001). CONCLUSION: The greater vergence adaptation observed in children may impact upon the clinical assessment of their binocular vision, especially heterophoria measurement which may require longer periods of dissociation than previously recommended, and might also ultimately be partly responsible for the predominant development of esodeviations during childhood

Effect of near-vision addition lenses on the accuracy of the accommodative response.

BACKGROUND: Addition lenses (adds) are frequently used to increase the accuracy of the near-vision focusing response, and may also play a role in the prevention or retardation of refractive error development. However, following the introduction of such a lens, if the accommodative response is reduced by an amount equal to the magnitude of the near add, then the resulting accommodative error (and degree of retinal defocus) would remain unchanged. METHODS: This study measured the accommodative response in 28 subjects while they viewed a near target binocularly, either through their distance refractive correction alone or this correction combined with a +0.75 D, +1.50 D, +2.00 D, or +2.50 D near add. RESULTS: The mean findings demonstrated a small (0.03 D) lead of accommodation to the near target through the distance correction, and monotonically increasing leads of accommodation with larger adds. Further, the additional lens power required to reduce the accommodative error to zero correlated significantly with the initial accommodative error. CONCLUSIONS: Near addition lenses may actually increase the degree of retinai defocus for individuals who manifest small accommodative errors.

Evaluation of clinical techniques to measure tonic accommodation.

Previous studies have advocated the use of a degraded accommodative stimulus to assess the value of tonic accommodation (TA) under clinical conditions. This study has attempted to determine the efficacy of two such clinically applicable techniques, i.e., viewing a low spatial frequency (approximately 0.1 cpd) difference of Gaussian (DOG) grating or a retinoscope beam in an otherwise dark room. Additionally the accommodative response (AR) was measured in darkness. The data indicate that these clinical techniques did provide a degraded stimulus to accommodation. However, measures of AR recorded when fixating the clinical targets did not correlate with the values of AR obtained in darkness. This lack of correlation suggests that the responses obtained when viewing either the DOG target or retinoscope beam may not represent a veridical measure of TA.

Comparison of accommodative adaptation using laser and infra-red optometers.

Previous investigations have reported differences in the rate of decay of accommodative adaptation depending on the form of optometer used to assess dark-focus (DF). This study has used both laser and infra-red optometers to measure pre- and post-task values of DF in 10 subjects. DF was assessed before and immediately after an 8 min near-vision task performed at the subjective near-point of accommodation. Examination of the data from the two optometers revealed significant differences in both magnitude and distribution of pre-task DF. Additionally variations in the post- to pre-task shift in DF were observed between the two methods of assessment. Using the laser optometer, six subjects exhibited positive adaptation following the near-task which was not apparent with the infra-red optometer. The data suggest that both instruments may not be sampling open-loop accommodation; the laser optometer is particularly vulnerable to extraneous influences.

Tonic vergence and vergence adaptation.

In the absence of an adequate visual stimulus, the eyes are typically converged by approximately 0.25 to 0.75 meter angles (MA). This vergence response (VR) was believed to reflect the level of tonic innervation to the extraocular muscles, and accordingly has been termed tonic vergence (TV). However, this estimation fails to consider the magnitude of the anatomical position of rest. The true typical value of TV is approximately 23 degrees. This paper will consider various aspects of this parameter, including both clinical and laboratory methods of measurement, and the relationship between TV and the distance heterophoria. In addition, the role of vergence (or prism) adaptation, i.e., the apparent change in TV after periods of sustained fixation, is discussed. This shift appears to result from the relatively prolonged decay of the slow fusional vergence response (VR), with no evidence for a change in the level of tonic innervation. On occasion, the decay of slow fusional vergence may take hours or even days to reach completion. This extended rate of decay will have a significant impact upon the clinical measurement of a number of binocular parameters, most notably the assessment of heterophoria under truly dissociated conditions (i.e., in the absence of any fusional VR). Furthermore, both the magnitude and rate of decay of vergence adaptation appear to vary with age, as well as the presence of oculomotor imbalance. It is concluded that the output of the slow fusional vergence mechanism, as reflected by the degree of vergence adaptation, makes a major contribution to the aggregate, sustained VR in most visually normal patients.

Accommodative error, adaptation and myopia.

Accommodative adaptation, resulting from the sustained output of slow blur-driven accommodation during the course of a sustained near-vision task, has generally been assessed under open-loop conditions. This study examined whether adaptation influences closed-loop accommodation during the course of a sustained near-vision task. Accommodative adaptation was assessed in 18 fully-corrected subjects by comparing pre- and post-task values of dark accommodation recorded objectively with an infra-red optometer. Subjects performed a continuous 10 min binocular near-vision task at a viewing distance of 33 cm, with the within-task accommodative response being assessed at 1 min intervals during this period. Subjects were categorized into adaptors (N = 11) and non-adaptors (N = 7) on the basis of whether their initial 10 sec post-task adaptation exceeded +0.30D. The adapting group exhibited a significant decline in the lag of accommodation during the first 3 min of the near-task, whereas no significant change in the within-task response over time was observed in the non-adapting group. These results indicate that accommodative adaptation increases the accuracy of the within-task, closed-loop accommodative response. Furthermore, we speculate that a deficit in accommodative adaptation, being accompanied by increased retinal defocus during near fixation, may contribute to the development of nearwork-induced myopia.

Synkinesis of accommodation and vergence in late-onset myopia.

The accommodative response (AR) to disparity-vergence and blur stimuli was determined for 45 subjects; 15 emmetropes, 15 late-onset myopes (LOM's), and 15 early-onset myopes (EOM's). The accommodative response was measured at approximately 1-s intervals for 50 s using an objective infrared optometer. Disparity-driven accommodation was induced by a 4 delta base-out prism at accommodative stimulus levels of 2.50 and 3.25 D. LOM's show significantly higher levels of disparity-induced accommodation when compared with the other two refractive groups. Blur-induced accommodation was produced by increasing the accommodative stimulus from 2.50 to 3.25 D with no concomitant change in vergence stimulus. EOM's exhibit less blur-induced accommodation compared with LOM's and emmetropes. These results are discussed with reference to differences in accommodation-vergence synkinesis between LOM's and EOM's, and in relation to the etiology of late-onset myopia.

Accommodative adaptation induced by sustained disparity-vergence.

Pre- and post-task measures of dark focus (DF) were used to assess the response of the accommodative system to within-task disparity-vergence in 10 late-onset myopes (LOM's) and 10 emmetropes. Disparity was induced by 3 and 6 delta base-out prisms imposed during a 3 D near-vision task undertaken for 3- and 10-min periods. Accommodation was measured after the task at 1-s intervals over a 90-s period using an objective infrared optometer to determine post-task regression of DF toward pretask values. After the 3-min task both groups show a reduction in DF adaptation with increasing disparity-vergence. After the 10-min task, disparity continues to have a significant effect on accommodative adaptation in LOM's but not in emmetropes, suggesting diminished prism adaptation in LOM's. The implications of these findings are discussed with regard to both current models of accommodation-vergence interaction and the etiology of late-onset myopia.

Assessment of the CA/C ratio in a myopic population.

The convergent accommodation/convergence (CA/C) ratio was measured in 30 subjects comprising 10 late-onset myopes (LOM's), i.e., myopia onset at 15 years of age or later, 10 early-onset myopes (EOM's), and 10 emmetropes. The accommodation loop was opened by two methods: (1) the subject viewed a 0.1-mm diameter spotlight at distances of 33 and 100 cm and (2) the subject viewed near-type (viewing distance 33 cm) through 0.5-mm pinholes. Convergence was stimulated by the introduction of 3 and 6 delta base-out prisms before the right eye and the accommodative response of the left eye was measured using an objective infrared optometer (Canon Autoref R-1). There was no significant difference in CA/C between the three refractive groups with either method. The implications of this finding are discussed with reference to previous work on accommodative convergence/accommodation (AC/A) and disparity-induced accommodation and in relation to accommodation-vergence synkinesis in late-onset myopia.

Temporal aspects of accommodative adaptation.

Pre- and post-task measures of dark focus (DF) were used to assess accommodative adaptation induced by brief near-vision tasks in 10 late-onset myopes (LOM's) and 10 emmetropes. The degree of adaptation was examined after tasks of 15, 30, and 45 s duration. Accommodation was measured after the task at 1 s intervals over a 90 s period using an objective infrared optometer. Emmetropic subjects showed a significant increase in DF during the first 10 s of post-task recording, which regressed to the pre-task value within a further 20 to 30 s. No significant difference in post-task accommodative regression was observed after the three task durations. Similar findings were observed for LOM's after the 15 and 30 s tasks. However, after the 45 s task, LOM's exhibited a marked negative shift in DF during the 10 to 50 s post-task period. Instillation of a beta adrenergic antagonist attenuated this negative shift, suggesting that it was mediated via beta adrenergic innervation to the ciliary muscle.

Disparity-induced accommodation in late-onset myopia.

The effect of disparity-vergence on the accommodation response (AR) was measured in 10 late-onset myopes (LOMs) and 10 emmetropic subjects during the course of a 10 minute near-vision task (working distance 33 cm). Disparity was induced by the introduction of 3 and 6 delta base-out prisms placed before the right eye, and the resulting AR for the left eye was measured at 1 min intervals using an objective infra-red optometer. LOMs showed a significant increase in AR with increasing disparity whereas emmetropes showed no significant difference in AR for all disparity conditions. The implications of these findings are discussed with reference to the aetiology of late-onset myopia.