The binocular accommodative response in uncorrected ametropia.

PURPOSE: To measure the changes in astigmatism and in the degree of anisometropia when ametropes respond to accommodative stimulation. METHODS: The accommodative responses of ametropes were binocularly measured with an improved photorefractometer (PR-1100), which objectively measured binocular refraction in all meridians simultaneously, when a visual fixation target was shown in natural space at 5 and 0.5 m. RESULTS: (1) Changes of astigmatism and anisometropia occur during binocular accommodation. (2) Changes of astigmatism mainly result from lag of accommodation in the horizontal meridian. (3) Changes of anisometropia result from the effort to focus. (4) The interaction of both eyes is suggested as the cause of the changes of astigmatism and anisometropia with accommodation. (5) In the majority of strong anisometropes (nonoverlapping group in this paper), the magnitude of anisometropia decreases (approaching isometropia) with accommodation. CONCLUSION: Changes in astigmatism and anisometropia can occur during accommodation, and these interactions of both eyes with accommodation may contribute to the development and maintenance of binocular function.