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Related Experiment Videos

[Dissociated near reflex and accommodative convergence excess].

M Gräf1, R Becker, S Kloss

  • 1Augenklinik für Schielbehandlung und Neuroophthalmologie, Justus-Liebig-Universität, Giessen. michael.h.graef@augen.med.uni-giessen.de

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|January 14, 2005
PubMed
Summary

This study highlights a rare case of a near reflex only in the left eye of an 8-year-old boy. Bifocal glasses corrected this visual anomaly, restoring binocular function and stereopsis.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Pediatric Optometry

Background:

  • The near reflex, crucial for clear vision at close distances, involves accommodation and pupillary constriction.
  • Disruptions in the near reflex can significantly impact visual function and binocularity.

Observation:

  • An 8-year-old boy presented with a near reflex exclusively elicited when his left eye was fixing (LF), but absent when his right eye was fixing (RF).
  • Initial examination revealed reduced visual acuity at near and significant esotropia at 3 meters when the left eye was fixing.
  • Accommodation and pupillary near reaction were impaired during right eye fixation.

Findings:

  • During left eye fixation, retinoscopy demonstrated 8 D of accommodation and normal pupillary constriction.
  • The patient exhibited esophoria at distance and varying phorias/tropias at near, dependent on fixation eye.

Related Experiment Videos

  • Correction with bifocal glasses normalized binocular alignment (orthotropia) and enabled stereopsis at near.

    • Implications:

    • This case underscores the importance of assessing eye-specific responses within the near reflex system.
    • Bifocal correction can be an effective treatment for complex binocular vision anomalies involving the near reflex.
    • Further research into the neural underpinnings of asymmetric near reflex responses is warranted.