The effect of proximity on open-loop accommodation responses measured with pinholes.

Open-loop accommodation levels were measured in 41 healthy, young subjects using a Shin-Nippon SRW-5000 autorefractor in the three viewing conditions: a small physical pinhole pupil (SP), an optically projected pinhole in Maxwellian view (MV) and in the dark (DF). The target viewed through the pinholes was a high-contrast letter presented at 0 D vergence in a +5 D Badal lens system. Overall, results showed that SP open-loop accommodation levels were significantly higher than MV and DF levels. Subjects could be divided into two distinct subgroups according to their response behaviour: responders to the proximal effect of the small physical pinhole (SP accommodation > MV accommodation) and non-responders to the proximal effect of the small physical pinhole (SP accommodation approximately MV accommodation). Correlation analysis demonstrated that open-loop accommodation for both pinhole conditions was correlated with DF for the responders, while for the non-responders SP and MV accommodation were correlated, but were not related to DF accommodation. This suggests that under open-loop conditions some individuals' accommodation levels are mainly affected by proximal and cognitive factors (responders) while others are guided primarily by the presence of the more distal target (non-responders). In conclusion, MV reduces the proximal effect of the physical pinhole and produces open-loop accommodation responses which are more consistent than SP and DF responses.