A novel experimental method for measuring vergence and accommodation responses to the main near visual cues in typical and atypical groups

Binocular disparity, blur, and proximal cues drive convergence and accommodation. Disparity is considered to be the main vergence cue and blur the main accommodation cue. We have developed a remote haploscopic photorefractor to measure simultaneous vergence and accommodation objectively in a wide range of participants of all ages while fixating targets at between 0.3 and 2 m. By separating the three main near cues, we can explore their relative weighting in three-, two-, one-, and zero-cue conditions. Disparity can be manipulated by remote occlusion; blur cues manipulated by using either a Gabor patch or a detailed picture target; looming cues by either scaling or not scaling target size with distance. In normal orthophoric, emmetropic, symptom-free, naive visually mature participants, disparity was by far the most significant cue to both vergence and accommodation. Accommodation responses dropped dramatically if disparity was not available. Blur only had a clinically significant effect when disparity was absent. Proximity had very little effect. There was considerable interparticipant variation. We predict that relative weighting of near cue use is likely to vary between clinical groups and present some individual cases as examples. We are using this naturalistic tool to research strabismus, vergence and accommodation development, and emmetropization.

Gender differences in early accommodation and vergence development

A remote haploscopic photorefractor was used to assess objective binocular vergence and accommodation responses in 157 full-term healthy infants aged 1-6 months while fixating a brightly coloured target moving between fixation distances at 2, 1, 0.5 and 0.33 m. Vergence and accommodation response gain matured rapidly from 'flat' neonatal responses at an intercept of approximately 2 dioptres (D) for accommodation and 2.5 metre angles(MA) for vergence, reaching adult-like values at 4 months. Vergence gain was marginally higher in females (p = 0.064), but accommodation gain (p = 0.034) was higher and accommodative intercept closer to zero (p = 0.004) in males in the first 3 months as they relaxed accommodation more appropriately for distant targets. More females showed flat accommodation responses (p = 0.029). More males behaved hypermetropically in the first two months of life, but when these hypermetropic infants were excluded from the analysis, the gender difference remained. Gender differences disappeared after three months. Data showed variable responses and infants could behave appropriately and simultaneously on both, neither or only one measure at all ages. If accommodation was appropriate (gain between 0.7 and 1.3; r(2) > 0.7) but vergence was not, males over- and under-converged equally, while the females who accommodated appropriately were more likely to overconverge (p = 0.008). The apparent earlier maturity of the male accommodative responses may be due to refractive error differences but could also reflect gender-specific male preference for blur cues while females show earlier preference for disparity, which may underpin the earlier emerging, disparity dependent, stereopsis and full vergence found in females in other studies.

Can misalignments in typical infants be used as a model for infantile esotropia?

PURPOSE. To investigate the nature of early ocular misalignments in human infants to determine whether they can provide insight into the etiology of esotropia and, in particular, to examine the correlates of misalignments. METHODS. A remote haploscopic photorefraction system was used to measure accommodation and vergence in 146 infants between 0 and 12 months of age. Infants underwent photorefraction immediately after watching a target moving between two of five viewing distances (25, 33, 50, 100, and 200 cm). In some instances, infants were tested in two conditions: both eyes open and one eye occluded. The resultant data were screened for instances of large misalignments. Data were assessed to determine whether accommodative, retinal disparity, or other cues were associated with the occurrence of misalignments. RESULTS. The results showed that there was no correlation between accommodative behavior and misalignments. Infants were more likely to show misalignments when retinal disparity cues were removed through occlusion. They were also more likely to show misalignments immediately after the target moved from a near to a far position in comparison to far-to-near target movement. DISCUSSION. The data suggest that the prevalence of misalignments in infants of 2 to 3 months of age is decreased by the addition of retinal disparity cues to the stimulus. In addition, target movement away from the infant increases the prevalence of misalignments. These data are compatible with the notion that misalignment are caused by poor sensitivity to targets moving away from the infant and support the theory that some forms of strabismus could be related to failure in a system that is sensitive to the direction of motion.

The development of convergence and accommodation

Aim: To review current literature on the development of convergence and accommodation. The accommodation and vergence systems provide the foundation upon which bifoveal binocular single vision develops. Deviations from their normal development not only are implicated in the aetiology of convergence anomalies, accommodative anomalies and strabismus, but may also be implicated in failure of the emmetropisation process. Method: This review considers the problems of researching the development of accommodation and vergence in infants and how infant research has had to differ from adult methods. It then reviews and discusses the implications of current research into the development of both systems and their linkages. Results: Vergence and accommodation develop rapidly in the first months of life, with accommodation changing from relatively fixed myopic focus in the neonatal period to adult-like responses by 4 months of age. Vergence develops gradually and becomes more accurate after 4 months of age, but has been demonstrated in infants well before the age that binocular disparity detection mechanisms are thought to develop. Hypotheses for this early vergence mechanism are discussed. The relationship between accommodation and vergence shows much more variability in infants than adult literature has found, but this apparent adult/infant difference may be partly attributed to methodological differences rather than maturational change alone. Conclusions: Variability and flexibility characterise infant responses. This variability may enable infants to develop a flexible and robust binocular system for later life. Studies of infant visual cue use may give clues to the aetiology of strabismus and refractive error.

Humans ignore motion and stereo cues in favor of a fictional stable world

As we move through the world, our eyes acquire a sequence of images. The information from this sequence is sufficient to determine the structure of a three-dimensional scene, up to a scale factor determined by the distance that the eyes have moved [1, 2]. Previous evidence shows that the human visual system accounts for the distance the observer has walked [3,4] and the separation of the eyes [5-8] when judging the scale, shape, and distance of objects. However, in an immersive virtual-reality environment, observers failed to notice when a scene expanded or contracted, despite having consistent information about scale from both distance walked and binocular vision. This failure led to large errors in judging the size of objects. The pattern of errors cannot be explained by assuming a visual reconstruction of the scene with an incorrect estimate of interocular separation or distance walked. Instead, it is consistent with a Bayesian model of cue integration in which the efficacy of motion and disparity cues is greater at near viewing distances. Our results imply that observers are more willing to adjust their estimate of interocular separation or distance walked than to accept that the scene has changed in size.

Stereoscopic acuity and observation distance

The amount of depth perceived from a fixed pattern of horizontal disparities varies with viewing distance. We investigated whether thresholds for discriminating stereoscopic corrugations at a range of spatial frequencies were also affected by viewing distance or whether they were determined solely by the angular disparity in the stimulus prior to scaling. Although thresholds were found to be determined primarily by disparity over a broad range of viewing distances, they were on average a factor of two higher at the shortest viewing distance (28.5 cm) than at larger viewing distances (57 to 450 cm). We found the same pattern of results when subjects' accommodation was arranged to be the same at all viewing distances. The change in thresholds at close distances is in the direction expected if subjects' performance is limited by a minimum perceived depth.

Cross validation and segment support for stereo belief propagation

Typically, algorithms for generating stereo disparity maps have been developed to minimise the energy equation of a single image. This paper proposes a method for implementing cross validation in a belief propagation optimisation. When tested using the Middlebury online stereo evaluation, the cross validation improves upon the results of standard belief propagation. Furthermore, it has been shown that regions of homogeneous colour within the images can be used for enforcing the so-called "Segment Constraint". Developing from this, Segment Support is introduced to boost belief between pixels of the same image region and improve propagation into textureless regions.

Self-assembled healable materials through a combination of pi-pi stacking and hydrogen bonding

The discovery of polymers with stimuli responsive physical properties is a rapidly expanding area of research. At the forefront of the field are self-healing polymers, which, when fractured can regain the mechanical properties of the material either autonomically, or in response to a stimulus. It has long been known that it is possible to promote healing in conventional thermoplastics by heating the fracture zone above the Tg of the polymer under pressure. This process requires reptation and subsequent re-entanglement of macromolecules across the fracture void, which serves to bridge, and ‘heal’ the crack. The timescale for this mechanism is highly dependent on the molecular weight of the polymer being studied. This process is in contrast to that required to affect healing in supramolecular polymers such as the plasticised, hydrogen bonded elastomer reported by Leibler et al. The disparity in bond energies between the non-covalent and covalent bonds within supramolecular polymers results in fractures propagating through scission of the comparatively weak supramolecular interactions, rather than through breaking the stronger, covalent bonds. Thus, during the healing process the macromolecules surrounding the fracture site only need sufficient energy to re-engage their supramolecular interactions in order to regenerate the strength of the pristine material. Herein we describe the design, synthesis and optimization of a new class of supramolecular polymer blends that harness the reversible nature of pi-pi stacking and hydrogen bonding interactions to produce self-supporting films with facile healable characteristics.

Decreased accommodation during decompensation of distance exotropia

Objective. Disparity cues can be a major drive to accommodation via the CA/C (convergence accommodation to convergence) linkage but, on decompensation of exotropia, disparity cues are extinguished by suppression, so this drive is lost. This study investigated accommodation and vergence responses to disparity, blur and proximal cues in a group of distance exotropes aged between 4-11 years both during decompensation and when exotropic. Methods. 19 participants with distance exotropia were tested using a PlusoptiXSO4 photorefractor set in a remote haploscopic device which assessed simultaneous vergence and accommodation to a range of targets incorporating different combinations of blur, disparity and proximal cues at four fixation distances between 2m and 33cm. Responses on decompensation were compared to those from the same children when their deviation was controlled. Results. Manifest exotropia was more common in the more impoverished cue conditions. When decompensated for near, mean accommodation gain for the all-cue (naturalistic) target reduced significantly (p<0.0001), with resultant mean under-accommodation of 2.33D at 33cm. The profile of near cues usage changed after decompensation, with blur and proximity driving residual responses, but these remaining cues did not compensate for loss of accommodation caused by the removal of disparity. Conclusions. Accommodation often reduces on decompensation of distance exotropia as the drive from convergence is extinguished, providing a further reason to try to prevent decompensation for near.

Evidence that convergence rather than accommodation controls intermittent distance exotropia

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. 19 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 2m and 33cm. Stimulus and response AC/A and CA/C ratios were calculated. Results. Accommodation responses for near targets (p=0.017) response gains (p=0.026) were greater in the exotropes than 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 over-accommodation 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.

The use of cues to convergence and accommodation in naive, uninstructed participants

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.

Distributed multimedia quality: the user perspective

Distributed multimedia supports a symbiotic infotainment duality, i.e. the ability to transfer information to the user, yet also provide the user with a level of satisfaction. As multimedia is ultimately produced for the education and / or enjoyment of viewers, the user’s-perspective concerning the presentation quality is surely of equal importance as objective Quality of Service (QoS) technical parameters, to defining distributed multimedia quality. In order to extensively measure the user-perspective of multimedia video quality, we introduce an extended model of distributed multimedia quality that segregates quality into three discrete levels: the network-level, the media-level and content-level, using two distinct quality perspectives: the user-perspective and the technical-perspective. Since experimental questionnaires do not provide continuous monitoring of user attention, eye tracking was used in our study in order to provide a better understanding of the role that the human element plays in the reception, analysis and synthesis of multimedia data. Results showed that video content adaptation, results in disparity in user video eye-paths when: i) no single / obvious point of focus exists; or ii) when the point of attention changes dramatically. Accordingly, appropriate technical- and user-perspective parameter adaptation is implemented, for all quality abstractions of our model, i.e. network-level (via simulated delay and jitter), media-level (via a technical- and user-perspective manipulated region-of-interest attentive display) and content-level (via display-type and video clip-type). Our work has shown that user perception of distributed multimedia quality cannot be achieved by means of purely technical-perspective QoS parameter adaptation.

Accommodation and vergence response gains to different near cues characterize specific esotropias

Aim. To describe preliminary findings of how the profile of the use of blur, disparity and proximal cues varies between non-strabismic groups and those with different types of esotropia. Design. Case control study Methodology. A remote haploscopic photorefractor measured simultaneous convergence and accommodation to a range of targets containing all combinations of binocular disparity, blur and proximal (looming) cues. 13 constant esotropes, 16 fully accommodative esotropes, and 8 convergence excess esotropes were compared with age and refractive error matched controls, and 27 young adult emmetropic controls. All wore full refractive correction if not emmetropic. Response AC/A and CA/C ratios were also assessed. Results. Cue use differed between the groups. Even esotropes with constant suppression and no binocular vision (BV) responded to disparity in cues. The constant esotropes with weak BV showed trends for more stable responses and better vergence and accommodation than those without any BV. The accommodative esotropes made less use of disparity cues to drive accommodation (p=0.04) and more use of blur to drive vergence (p=0.008) than controls. All esotropic groups failed to show the strong bias for better responses to disparity cues found in the controls, with convergence excess esotropes favoring blur cues. AC/A and CA/C ratios existed in an inverse relationship in the different groups. Accommodative lag of >1.0D at 33cm was common (46%) in the pooled esotropia groups compared with 11% in typical children (p=0.05). Conclusion. Esotropic children use near cues differently from matched non-esotropic children in ways characteristic to their deviations. Relatively higher weighting for blur cues was found in accommodative esotropia compared to matched controls.

Convergence accommodation trumps accommodative convergence

Purpose. This symposium contribution presents research that shows that disparity cues within a near stimulus drive not only vergence but also most of the accommodation. Be-cause blur is a weaker cue, accommodative convergence is therefore only of minor significance for most individuals. Methods. The Infant Vision Laboratory at the University of Reading uses a Power Ref II photorefractor to collect simultaneous accommodation and convergence data from participants fixating targets moving in depth. By manipulating target characteristics, we have been able to test how blur, disparity and proximal cues each contribute to driving responses. Results. Results from a series of studies over the past 12 years have contributed to a coherent body of evidence suggesting that disparity cues override blur and proximity cues in most individuals. Some strabismic patients do use blur as a more strongly weighted cue, and this strategy could contribute to their symptoms, clinical characteristics and response to treatment. Conclusion. Although convergence accommodation is extremely difficult to measure clinically, clinicians should be aware of its importance in binocular vision and strabismus. Although CA/C relationships typically seem more important than AC/A, bo th only partly explain the interplay between convergence and accommodation.

Understanding the WTA–WTP gap: Attitudes, feelings, uncertainty and personality

We present an experiment designed to study the psychological basis for the willingness to accept (WTA)–willingness to pay (WTP) gap. Specifically, we conduct a standard WTA–WTP economic experiment to replicate the gap and include in it five additional instruments to try to follow the psychological processes producing it. These instruments are designed to measure five psychological constructs we consider especially relevant: (1) attitudes, (2) feelings, (3) familiarity with the target good, (4) risk attitudes, and (5) personality. Our results provide important new insights into the psychological foundations of the WTA–WTP disparity, which can be used to organize some major previous results and cast serious doubts on the claim that the gap might be just a consequence of inappropriate experimental practice.