Night myopia is reduced in binocular vision.

Night myopia, which is a shift in refraction with light level, has been widely studied but still lacks a complete understanding. We used a new infrared open-view binocular Hartmann-Shack wave front sensor to quantify night myopia under monocular and natural binocular viewing conditions. Both eyes' accommodative response, aberrations, pupil diameter, and convergence were simultaneously measured at light levels ranging from photopic to scotopic conditions to total darkness. For monocular vision, reducing the stimulus luminance resulted in a progression of the accommodative state that tends toward the subject's dark focus or tonic accommodation and a change in convergence following the induced accommodative error. Most subjects presented a myopic shift of accommodation that was mitigated in binocular vision. The impact of spherical aberration on the focus shift was relatively small. Our results in monocular conditions support the hypothesis that night myopia has an accommodative origin as the eye progressively changes its accommodation state with decreasing luminance toward its resting state in total darkness. On the other hand, binocularity restrains night myopia, possibly by using fusional convergence as an additional accommodative cue, thus reducing the potential impact of night myopia on vision at low light levels.

Binocular open-view instrument to measure aberrations and pupillary dynamics.

We have designed and built a binocular Hartmann-Shack wave-front sensor using a single microlens array and camera for real-time aberration measurement of both eyes in an open-view configuration. Furthermore, the use of a long wavelength (1050 nm) laser diode makes the illumination source completely invisible, so that measurements can be unobtrusively performed while the subject stares at the visual world under realistic conditions. The setup provides a large dynamic range and simultaneous measurements of convergence, pupil size, accommodation, and aberrations. The open-view design not only offers the possibility of measuring the subject's ocular optics under natural conditions but also allows coupling the device with other existing vision testing instruments and setups, which increases its potential to become a powerful tool for different visual optics studies.

The accommodative ciliary muscle function is preserved in older humans.

Presbyopia, the loss of the eye's accommodation capability, affects all humans aged above 45-50 years old. The two main reasons for this to happen are a hardening of the crystalline lens and a reduction of the ciliary muscle functionality with age. While there seems to be at least some partial accommodating functionality of the ciliary muscle at early presbyopic ages, it is not yet clear whether the muscle is still active at more advanced ages. Previous techniques used to visualize the accommodation mechanism of the ciliary muscle are complicated to apply in the older subjects, as they typically require fixation stability during long measurement times and/or to have an ultrasound probe directly in contact with the eye. Instead, we used our own developed method based on high-speed recording of lens wobbling to study the ciliary muscle activity in a small group of pseudophakic subjects (around 80 years old). There was a significant activity of the muscle, clearly able to contract under binocular stimulation of accommodation. This supports a purely lenticular-based theory of presbyopia and it might stimulate the search for new solutions to presbyopia by making use of the remaining contraction force still presented in the aging eye.

Dynamics of the near response under natural viewing conditions with an open-view sensor.

We have studied the temporal dynamics of the near response (accommodation, convergence and pupil constriction) in healthy subjects when accommodation was performed under natural binocular and monocular viewing conditions. A binocular open-view multi-sensor based on an invisible infrared Hartmann-Shack sensor was used for non-invasive measurements of both eyes simultaneously in real time at 25Hz. Response times for each process under different conditions were measured. The accommodative responses for binocular vision were faster than for monocular conditions. When one eye was blocked, accommodation and convergence were triggered simultaneously and synchronized, despite the fact that no retinal disparity was available. We found that upon the onset of the near target, the unblocked eye rapidly changes its line of sight to fix it on the stimulus while the blocked eye moves in the same direction, producing the equivalent to a saccade, but then converges to the (blocked) target in synchrony with accommodation. This open-view instrument could be further used for additional experiments with other tasks and conditions.