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					Accomodation, Fusion and Binocularity Amy C. Nau, OD Outline Accommodation  Binocular sensory function  Vergence  Pathophysiology of common accommodative and binocular anomolies  Ken Cuifredda, OD PhD, Glen McCormack, OD PhD in Borish, Clinical Refraction History of Accomodation Descartes (1677)- proposes lenticular based focusing  Thomas Young- (1801)- demonstrates that the lens changes shape  Hermann von Helmholtz (1866)- first accurate description of accommodative processes  Physiology of Accommodation The Eye Ciliary m. relaxed Ciliary m. contracts http://hyperphysics.phy-astr.gsu.edu/hbase/vision/imgvis/accom2.gif Neural basis for accommodation Magnocellular LGN http://bicmra.usuhs.mil/MRA/Histology/Eye/Images/eye01.jpg http://static.howstuffworks.com/gif/brain-intro.gif Neural basis for accommodation EWN- CN3 (PS)-CilGShort Cil N/Long Cil N. http://info.med.yale.edu/caim/cnerves/cn3/cn3_graphics/cn3_9.jpg Types of Accommodation Reflex, +/ Vergence, +/ Proximal, +/ Tonic, +/ Systems Analysis of Accommodation Adapt. tonic - Stimulus (D) S retina Depth of focus gain S Cm/lens Reflex Accom + Influences on Blur Accommodation Responses  Optical Cues    Nonretinal Image  H.O. Aberrations Microfluctuations in EOM and AR      Non Optical Cues      Size Proximity Apparent Distance Disparate retinal images Monocular depth cues  Vestibular stimulation Mood Effort Cognitive Demand Instruction set Retinal Image       Frequency Contrast Eccentricity Luminance Size Depth of focus Fusion    How do the two eyes, separated in space, give us a single precept? How are the eye movements coordinated with the retinal image to maintain singularity? How does stereo vision enhance our perceptions of our surroundings? Stereograms http://www.lri.fr/~marche/images/cameleon-3d.gif Space Perception Object Space “the real world”  Visual Space - the world as it is captured by our retina and processed by the visual cortex.  Visual space must reproduce object space  The Cyclopean Eye We percieve the world as though we have one eye which exists between our two eyes.  “egocenter”  http://bearah718.tripod.com/sitebuildercontent/sitebuilderpictures/cyclops.jpg Visual Localization and Visual Direction  Egocentric localization of an object Where is the object in 3D space in relation to my own position?  Can judge distance in a unit of measurement (i.e., feet or meters)   Imaginary arrow from the cyclopean eye to the object (i.e. straight ahead, etc.) Egocentric localization  The sense of direction from retinal locus is a property of oculo-cortical mapping Each retinal point has a location relative to other retinal points in this map  Local sign is the term that refers to the unique direction for each retinal point.   Related to va and retinal location (fovea vs periph), amblyopia Principal visual direction Elicits the sensation of “looking” at something  Associated with the fixation point /origin  Center of anatomic fovea  Center of oculocentric direction  Guides foveation   Registration… Example: Paretic strabismus   Past pointing test Used to detect labyrinth disease but also can be used for paretic eom.  Egocentric direction judgement errors when monocularly fixating with the paretic eye Depth and Distance Perception  Distance perception = absolute depth How far any object is from the observer, from another object, able to judge in meters, etc. Depth perception (relative), perception of relative proximity of one object to another or the relative depth between two or more points in space. Depth: coffee cup is 50% farther than pencil Distance: 10 cm Monocular Cues to Depth          Object distance form observer is inversely proportional to retinal image size. Linear/perspective Texture density Luminance variations, shadows, color Atmospheric perspective Overlay cue Parallax Head motion Kinetic depth effect http://www1.cs.columbia.edu/~paley/spring03/assignments/HW5/bg2020/size.jpg Visual cliff experiment. Are cues learned or innate? Binocular cues to stereopsis Separation of the eyes  Accommodation  Convergence  Stimulus to Stereopsis Lateral separation of eyes= different views of the world (binocular parallax)  Elicits convergence/divergence  The magnitude of horizontal disparity for any given point is a function of the lateral separation of the eyes divided by object distance  Binocular Contribution to Depth and Distance Perception Horizontal geometric disparity is insufficient to calculate percieved distance.  Registered convergence  Spatial Stereopsis Limits Retinal disparity is not compared with all retinal points  Actually any given retinal locus only interacts with a limited area of retinal points in the fellow eye  Horopter     Center of the region of stereopsis Defined by all those points in object space that stimulate corresponding retinal points (points in each eye that retain the same sense of visual direction). Any object not on the horopter may appear to be in different directions ot the two eyes. It is the center of range of binocularity and region of highest stereoscopic acuity Horoptor  Crossed disparity- closer to observer than the horopter,image is observed on opposite side , (images fall temporal)  Uncrossed disparity - object is farther from observer than the horopter (images are nasal from corresponding points ) observed on same side Measuring retinal disparity  Maddox rod test Exophoria- streak falls on temporal retina, stimulates crossed disparity  Esophoria-streak falls nasally, simulates uncrossed disparity.   Anomalous retinal correspondence_ identical sense of visual direction with very dissimilar retinal points Spatial Limits of Fusion      Occurs only when corresponding points are stimulated Small to moderate retinal disparities are stimulated. Pannum’s space the space around the current fixation point which can be fused, extents around 15 minarc. Outside this region, some qualitative depth can still be perceived, but stimuli can not be fused. Humans and many other animals sample the surrounding space by constantly changing the fixation point of their eyes. Nonspatial Limits of Fusion  As images become more dissimilar fusion is interrupted (color/shape etc). Diplopia Binocular rivalry Sustained suppression Luminance Luster  You can get partial fusion      Red green glasses….. Anomalous retinal correspondence Fine and Coarse Stereopsis  Fine: parvocellular, higher spatial frequency, smaller retinal disparities, stationary targets. Foveal vision, similar size and shape images necessary.  Coarse: magnocellular, lower spatial frequency, larger retinal disparities, moving targets, periphery, similarity of images not such an issue. (motion in depth mechanism) Local and Global Stereopsis   Stereo contributes to pattern recognition Randot: visual system performs interocular image disparity computations across binocular visual field in a process known as global stereopsis  Stereograms: When color and contrast reveal the form, dispartiy processing limited to the immediate vicinty of the form is sufficient to reveal the depth = local stereopsis.  Fine and coarse = local Fine= global  LOCAL STEREOPSIS http://archive.museophile.org/3d/pub/tunnel.gif Stereo Acuity Ability to discriminate very fine differences in depth from geometric disparity  Minimum geometric disparity that elicits a sensation of depth.  Fine- 2 sec arc  hyperacuity  Binocular Sensory Fusion Summary Single precept from two ocular images  Ensures visual space represents object space. (no diplopia)  Binocular Motor Function Eye Movements  support foveal vision   support stable retinal imagery   Supranuclear level- different from horizontal Torsional eye movements   Vestibular/optokinetic Vertical eye movements   Saccades/smooth pursuits/vergence Compensate for head tilts Hering’s law- motor embodiment of cyclopean vision Horizontal Vergence Movements Tonic, +/ Accommodative, +/ Proximal, +/ Fusional, +/ Maddox, 1893 Disparity Vergence (allows stereo) Vergence innervation is stimulated by retinal disparity  Corresponding retinal points are not stimulated  Purpose is to place targets of interest on the horopter to maximize steropsis  Coarse –v- Fine innervation  Feedback Control of Disparity Vergence and Fixation Disparity Disparity (MA) Pannum’s Area S gain S Adapt. tonic retina - EOMs + Verg. Resp. Convergence Accommodation Adapt. tonic - Stimulus (D) Depth of focus S S gain Cm/lens retina Reflex Accom + CA/C Disparity (MA) Pannum’s Area S gain S Adapt. tonic retina - EOMs + Verg. Resp. Accommodative Convergence Adapt. tonic Stimulus (D) Depth of focus S gain S Cm/lens retina Reflex Accom + AC/A CA/C Disparity (MA) Pannum’s Area S gain S Adapt. tonic retina - EOMs + Verg. Resp. Proximal Vergence Adapt. tonic Stimulus (D) Depth of focus S S Cm/lens retina Prox Accom gain Percieved Nearness gain Reflex Accom + AC/A Prox Vergence gain CA/C Disparity (MA) Pannum’s Area S gain S Adapt. tonic retina - EOMs + Verg. Resp. Pathophysiology of common binocular anomolies    Accommodative insufficiency Accommodative excess Accommodative infacility   Convergence Insufficiency Convergence Excess Accommodative Insufficiency  Accomodation is about 2D lower than age expected norms Ill sustained/fatigue  Paralysis or paresis  Unequal  Accommodative Excess  Accommodative response is greater than expected Accommodative spasm  Usually presents with convergence insufficiency  Accommodative Infacility Dynamics of latency/ velocity/ time constant are slower than normal  Accommodative amplitudes are normal  Difficulty changing focus from far to near and back.   flippers Convergence Insufficiency High near exophoria, low AC/A ratio, low positive relative convergence, excess accommodation at near  Poor or nonexistant convergent adaptation  Reduced accommodative vergence=low ac/a  Abnormallly high convergence accommodation  Convergence Insufficiency Adapt. tonic Stimulus (D) Depth of focus S S Cm/lens retina Prox Accom gain Percieved Nearness gain Reflex Accom + AC/A Prox Vergence gain CA/C Disparity (MA) Pannum’s Area S gain S Adapt. tonic retina - EOMs + Verg. Resp. Convergence Excess  High esophoria at near, high AC/A ratio, lag of accommodation Convergence Excess Adapt. tonic Stimulus (D) Depth of focus S S Cm/lens retina Prox Accom gain Percieved Nearness gain Reflex Accom + AC/A Prox Vergence gain CA/C Disparity (MA) Pannum’s Area S gain S Adapt. tonic retina - EOMs + Verg. Resp. Effect of blur on binocular vision BI prism and minus lenses: demand increases of negative disparity vergence innervation and positive reflex accomodation innervation  BO prism and plus lenses: demand increases of positive dispartiy vergence innervaiton and negative reflex accommodation innervaiton.  Summary- it is all connected.. http://www.mabot.com/images/2001/w2/brain-render.jpg
 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                            