A remote haploscopic video refractor was used to assess vergence and accommodation responses in a group of 32 emmetropic, orthophoric, symptom free, young adults naïve to vision experiments in a minimally instructed setting. Picture targets were presented at four positions between 2 m and 33 cm. Blur, disparity and looming cues were presented in combination or separately to asses their contributions to the total near response in a within-subjects design. Response gain for both vergence and accommodation reduced markedly whenever disparity was excluded, with much smaller effects when blur and proximity were excluded. Despite the clinical homogeneity of the participant group there were also some individual differences.

This study investigated the development of the link from accommodation to vergence in infants by occluding one eye thus removing binocular cues. Occluded adults continue to converge partially demonstrating that the accommodative drive to vergence (the AC/A link) and proximal cues are sufficient to drive vergence. For infants of all ages, AC/A ratios were found to be in the normal adult range. We conclude that infants can use monocular cues to drive vergence and that this occurs before the age when there is a substantial increase in the accuracy of oculomotor processes. There is flexibility in the developing visual system which is able to produce early vergence responses by relying upon alternative cues.

. Purpose:  This study considered whether vergence drives accommodation or accommodation drives vergence during the control of distance exotropia for near fixation. High accommodative convergence to accommodation (AC/A) ratios are often used to explain this control, but the role of convergence to drive accommodation (the CA/C relationship) is rarely considered. Atypical CA/C characteristics could equally, or better, explain common clinical findings. Methods:  Nineteen distance exotropes, aged 4–11 years, were compared while controlling their deviation with 27 non‐exotropic controls aged 5–9 years. Simultaneous vergence and accommodation responses were measured to a range of targets incorporating different combinations of blur, disparity and looming cues at four fixation distances between 2 m and 33 cm. Stimulus and response AC/A and CA/C ratios were calculated. Results:  Accommodation responses for near targets (p = 0.017) and response gains (p = 0.026) were greater in the exotropes than in the controls. Despite higher clinical stimulus AC/A ratios, the distance exotropes showed lower laboratory response AC/A ratios (p = 0.02), but significantly higher CA/C ratios (p = 0.02). All the exotropes, whether the angle changed most with lenses (‘controlled by accommodation’) or on occlusion (‘controlled by fusion’), used binocular disparity not blur as their main cue to target distance. Conclusions:  Increased vergence demand to control intermittent distance exotropia for near also drives significantly more accommodation. Minus lens therapy is more likely to act by correcting overaccommodation driven by controlling convergence, rather than by inducing blur‐driven vergence. The use of convergence as a major drive to accommodation explains many clinical characteristics of distance exotropia, including apparently high near stimulus AC/A ratios.

were rare, especially in the younger children, but increased with age. In pre-school children spectacles did not appear to be the salient feature in negative social judgements that has been found to occur in adults.