RESUMEN
Purpose: This study aimed to investigate the changes in ocular refraction and pupillary diameter during fixation on augmented reality (AR) images using a Maxwellian display. Methods: Twenty-two healthy young volunteers (average age, 20.7 ± 0.5 years) wore a Maxwellian display device in front of their right eye and fixated on an asterisk displayed on both a liquid-crystal display (real target) and a Maxwellian display (AR target) for 29 seconds (real as a baseline for 3 seconds, AR for 13 seconds, and real for 13 seconds) at distances of 5.0, 0.5, 0.33, and 0.2 meters. A binocular open-view autorefractometer was used to measure the ocular refraction and pupillary diameter of the left eye. Results: Accommodative (5.0 meters, 0.28 ± 0.29 diopter [D]; 0.5 meter, -0.12 ± 0.35 D; 0.33 meter, -0.43 ± 0.57 D; 0.2 meter, -1.20 ± 0.82 D) and pupillary (5.0 meters, 0.07 ± 0.22 mm; 0.5 meter, -0.08 ± 0.17 mm; 0.33 meter, -0.16 ± 0.20 mm; 0.2 meter, -0.25 ± 0.24 mm) responses were negative when the real target distances were farther away. The accommodative response was significantly and positively correlated with the pupillary response during fixation on the AR target (R2 = 0.187, P < 0.001). Conclusions: Fixating on AR images using a Maxwellian display induces accommodative and pupillary responses. Accommodative responses depend on the distance between real objects. Overall, the Maxwellian display does not completely eliminate accommodation in real space.