How good is the match between the plane of the text and the plane of focus during reading?

Because results from animal models demonstrate that retinal image defocus is a crucial factor in the visual control of eye growth, we have measured the precision of accommodation during reading at 1 m and at 30 cm distance. A newly developed photorefractor was used to sample both the refraction in the vertical meridian and direction of gaze at 25 Hz. Using these two parameters, a three-dimensional "refraction map" of the visual field was plotted. It showed the optic disc as an area with more myopic refractions and the course of refractions across a visual field of about +/- 25 deg. A special calibration scheme was employed to ensure that the precision of the refractions was 0.2 dpt or better (as estimated from the standard deviations of repeated measurements and the noise in the calibration curve). Twelve young adults (students from the lab) served as subjects. We found considerable inter-individual variability in the off-axis refractions but little variability among repeated measurements in the same subjects. Inter-individual variability reached a minimum in the foveal region. Both myopes wearing their spectacle corrections (n = 6) and emmetropes (n = 6) under-accommodated by about 0.3 D during reading at 30 cm distance but, at 1 m distance, only the emmetropes under-accommodated. Since both refraction groups under-accommodated similarly during reading at close distance, it remains unclear whether the small amount of defocus is critical for their future myopia development. Either accommodation errors differ at earlier times when myopia first appears (as suggested by the literature), or the subjects' eye growth was differently sensitive to defocus, or our simple protocol did not pick up existent differences in accommodation among the two groups.