ArticleStrabismus2013
The clinical near gradient stimulus AC/A ratio correlates better with the response CA/C ratio than with the response AC/A ratio.
Article in Strabismus, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- The Measurement and Clinical Implications of the CA/C Ratio in Binocular Vision: A Literature Review.The British and Irish orthoptic journal · 2026Review
- The Interaction between Vergence and Accommodation Cues in the Assessment of Fusional Vergence Range.Life (Basel, Switzerland) · 2024Article
- Comparisons of proximal vergence measures.Vision development and rehabilitation · 2020Article
- Article
- Disparity-driven vs blur-driven models of accommodation and convergence in binocular vision and intermittent strabismus.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2014Article
- Convergence insufficiency: Review of clinical diagnostic signs.Journal of optometryReview
Corrections and comments
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Authors and funding
2 authors at 1 institution in 2 countries.
Funding
Abstract
aimTo provide evidence that a near clinical gradient AC/A ratio could instead reflect the CA/C relationship (the accommodation driven by response to disparity).
designCase control study. METHODOLOGY: 27 emmetropic participants with heterophoria <4 PD, 19 with intermittent distance exotropia, and 17 with near exophoria >6 PD were tested. A remote haploscopic photorefractor, which can measure simultaneous convergence and accommodation to a range of targets containing all combinations of presence or absence of binocular disparity, blur, and proximal (looming) cues, was used to assess response AC/A and CA/C relationships. These were compared with clinical gradient AC/A ratios at near and distance fixation using alternate prism cover test and plus or minus lenses.
resultsAlthough the near and distance clinical AC/A ratios correlated weakly with each other (p = 0.03), neither clinical method correlated with the more accurate response AC/A ratio from the laboratory method (p = 0.88 and p = 0.93, respectively). The laboratory CA/C ratio correlated strongly with the near clinical AC/A ratio (p = 0.004) but only very weakly with the distance ratio (p = 0.16).
conclusionsThe "near gradient AC/A ratio" may actually reflect the CA/C linkage as the dissociation of the prism cover test disrupts vergence accommodation. If the near deviation diverges more with plus lenses, it may be because the lenses allow clear near vision without needing to recruit convergence accommodation to achieve it.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.