Birnbaum M H
J Am Optom Assoc. 1984 Nov;55(11):825-35.
The nearpoint visual stress theory holds that a tendency for convergence to localize closer than accommodation is intrinsic to the nearpoint visual demands imposed by our culture. A physiological model is presented, suggesting that this effector system mismatch arises from the activation of autonomic reflexes related to stress, vigilant attention and information-processing. Autonomic arousal exerts a cycloplegic-like effect. Excess accommodative effort, which must be exerted to achieve required accommodation, produces a tendency towards overconvergence. The demand for integration of accommodation and convergence, essential for efficient nearpoint function, is thus incompatible with our own physiology, since autonomic arousal is inherent in task demands for attention and mental effort associated with reading. Additionally, autonomic arousal is generated by the high levels of stress pervasive in our society. Various refractive, binocular and accommodative deviations may arise adaptively in order to resolve this mismatch and facilitate efficient nearpoint visual function. These nearpoint stress-induced visual disorders parallel stress-induced systemic illness in that both result from the activation of physiological processes which are inappropriate for the demands and stresses of our society.
近点视觉压力理论认为，在我们的文化对近点视觉的要求中，集合比调节更倾向于近点定位是内在的。本文提出了一个生理模型，表明这种效应器系统不匹配源于与压力、警觉性注意力和信息处理相关的自主反射的激活。自主唤醒产生类似睫状肌麻痹的作用。为了实现所需的调节而必须付出的过度调节努力会产生过度集合的倾向。因此，对于高效近点功能至关重要的调节和集合整合需求与我们自身的生理状况不兼容，因为自主唤醒是与阅读相关的注意力和脑力任务需求所固有的。此外，自主唤醒是由我们社会中普遍存在的高水平压力产生的。为了解决这种不匹配并促进高效的近点视觉功能，可能会适应性地出现各种屈光、双眼和调节偏差。这些近点压力诱发的视觉障碍与压力诱发的全身性疾病相似，因为两者都是由与我们社会的需求和压力不适应的生理过程激活所导致的。
