Lens induced aniso-accommodation.

Despite the evidence for consensual accommodation in response to consensual accommodative stimuli, only a few studies have investigated the binocular accommodative response to unequal (aniso) accommodative stimuli. Past studies investigating an unequal binocular accommodative response (aniso-accommodation) to aniso-accommodative stimuli have been limited by viewing conditions and measurement technique making the results, which were equivocal, difficult to interpret. This investigation addressed these limitations by the following design parameters: (1) monocular dichoptic blur cuese were provided in the binocular stimulus target to provide subjects feedback on their aniso-accommodative response and to alert the investigator of a monocular blur suppression response; (2) a training period was provided; (3) in the subjective method, each eye's stigma was positioned near the dichoptic letter viewed by the other eye. By this method, a true aniso-accommodative response could be differentiated from successive consensual responses; (4) a large range of aniso-accommodative stimuli was used, 0.50-3.0 D, presented in incremental steps of 0.5 D, allowing measurement of an average 0.75 D aniso-accommodative response for the highest (3.0 D) aniso-accommodative stimulus; (5) aniso-accommodation was measured as a function of viewing distance. For four of seven subjects, the gain of the aniso-accommodative response was significantly greater at near than at far viewing distances; (6) aniso-accommodation was confirmed objectively with measures of the response to steady state and step aniso-accommodative stimuli, using a binocular SRI Dual Purkinje Eye Tracker Optometer System. The aniso-accommodative response to step stimuli showed a very long latency period (about 11 s) and a response time of 4.5 s. A potential benefit of aniso-accommodation would be to overcome small amounts of uncorrected anisometropic refractive error. This would preserve fine stereo acuity which is impaired by unequal intraocular image contrast. Aniso-accommodation also may provide an appropriate efferent feedback signal for each eye's unique refractive error which could be used to guide developmental isometropization (attainment of equal refractive error in the two eyes.).