Understanding accommodative control in the clinic: Modeling latency and amplitude for uncorrected refractive error, presbyopia and cycloplegia

Understanding accommodative control in the clinic: Modeling latency and amplitude for uncorrected refractive error, presbyopia and cycloplegia by Read JCA, Maus G, Schor CM, ReadMausSchor2024.pdf (3.9 MiB) - Accommodation is the process of adjusting the eye's optical power so as to focus at different distances. Uncorrected refractive error and/or functional presbyopia mean that sharp focus may not be achievable for some distances, so observers experience sustained defocus. Here, we identify a problem with current models of accommodative control: They predict excessive internal responses to stimuli outside accommodative range, leading to unrealistic adaptation effects. Specifically, after prolonged exposure to stimuli outside range, current models predict long latencies in the accommodative response to stimuli within range, as well as unrealistic dynamics and amplitudes of accommodative vergence innervation driven by the accommodative neural controller. These behaviors are not observed empirically. To solve this issue, we propose that the input to blur-driven accommodation is not retinal defocus, but correctable defocus. Predictive models of accommodative control already estimate demand from sensed defocus, using a realistic “virtual plant” to estimate accommodation. Correctable defocus can be obtained by restricting this demand to values physically attainable by the eye. If we further postulate that correctable defocus is computed using an idealized virtual plant that retains a young accommodative range, we can explain why accommodative–convergence responses are observed for stimuli that are too near—but not too far—to focus on. We model cycloplegia as a change in gain, and postulate a form of neural myopia to explain the additional relaxation of accommodation often seen with cycloplegia. This model produces plausible predictions for the accommodative response and accommodative convergence signal in a wide range of clinically relevant situations

The stereoscopic anisotropy develops during childhood.

The stereoscopic anisotropy develops during childhood. by Serrano-Pedraza I, Herbert W, Villa-Laso L, Widdall M, Vancleef K, Read JCA, SerranoPedrazaHerbertVillaLasoWiddallVancleefRead2016.pdf (1.5 MiB) - PURPOSE:
Human vision has a puzzling stereoscopic anisotropy: horizontal depth corrugations are easier to detect than vertical depth corrugations. To date, little is known about the function or the underlying mechanism responsible for this anisotropy. Here, we aim to find out whether this anisotropy is independent of age. To answer this, we compare detection thresholds for horizontal and vertical depth corrugations as a function of age.
METHODS:
The depth corrugations were defined solely by the horizontal disparity of random dot patterns. The disparities depicted a horizontal or vertical sinusoidal depth corrugation of spatial frequency 0.1 cyc/deg. Detection thresholds were obtained using Bayesian adaptive staircases from a total of 159 subjects aged from 3 to 73 years. For each participant we computed the anisotropy index, defined as the log10-ratio of the detection threshold for vertical corrugations divided by that for horizontal.
RESULTS:
Anisotropy index was highly variable between individuals but was positive in 87% of the participants. There was a significant correlation between anisotropy index and log-age (r = 0.21, P = 0.008) mainly driven by a significant difference between children and adults. In 67 children aged 3 to 13 years, the mean anisotropy index was 0.34 ± 0.38 (mean ± SD, meaning that vertical thresholds were on average 2.2 times the horizontal ones), compared with 0.59 ± 0.55 in 84 adults aged 18 to 73 years (vertical 3.9 times horizontal). This was mainly driven by a decline in the sensitivity to vertical corrugations. Children had poorer stereoacuity than adults, but had similar sensitivity to adults for horizontal corrugations and were actually more sensitive than adults to vertical corrugations.
CONCLUSIONS:
The fact that adults show stronger stereo anisotropy than children raises the possibility that visual experience plays a critical role in developing and strengthening the stereo anisotropy.