ArticleInvestigative ophthalmology & visual science2017
The Response AC/A Ratio Before and After the Onset of Myopia.
Article in Investigative ophthalmology & visual science, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Prevalence of non-strabismic binocular vision anomalies and age-related changes in binocular vision among middle-aged and older adults: a systematic review.BMC ophthalmology · 2025Pooled it
- Accommodation response and spherical aberration during orthokeratology.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2020Trial
- Knowledge and Practices of South African Optometrists Regarding Childhood Myopia Management.Vision (Basel, Switzerland) · 2026Article
- Longitudinal Changes in Peripheral Refraction, Lag and Axial Length in Myopic Children Treated with Orthokeratology: A 12-Month Prospective Study.Children (Basel, Switzerland) · 2026Article
- A Shared Genetic Basis Underlying Myopia-Exotropia Comorbidity.Investigative ophthalmology & visual science · 2026Article
- Refractive status, visual behaviour, and parental myopia in Portuguese schoolchildren and adolescents.BMC pediatrics · 2026Article
- Impact of myopia and myopia control interventions on binocular vision: A narrative review.Indian journal of ophthalmology · 2026Review
- Human accommodative visuomotor function is driven by contrast through ON and OFF pathways and is enhanced in myopia.Cell reports · 2026Article
- Assessing the reliability of non-cycloplegic refraction in children: a machine learning approach based on non-cycloplegic parameters.Frontiers in public health · 2026Article
- Visual Training for Myopia Control: An Independent and Additive Inhibitor of Axial Growth.Clinical optometry · 2026Article
- The Measurement and Clinical Implications of the CA/C Ratio in Binocular Vision: A Literature Review.The British and Irish orthoptic journal · 2026Review
- Atropine-Loaded Contact Lens Sustained-Release Systems: A Narrative Review for the New Frontier for Myopia Management.Ophthalmology and therapy · 2026Review
- Comparison of accommodation and vergence parameters in early and late-onset myopic adults.BMC ophthalmology · 2025Observational
- IMI-Instrumentation for Myopia Management.Investigative ophthalmology & visual science · 2025Review
- Association of Attention-Deficit Hyperactivity Disorder With Myopia Among School Children.Investigative ophthalmology & visual science · 2025Article
- Scoping Review of the Role of Accommodation and Binocular Coordination in Myopia Onset and Progression.Clinical ophthalmology (Auckland, N.Z.) · 2025Review
- Impact of Wearing Defocus Incorporated Multiple Segments Spectacle Lenses for 12 Months on Accommodation and Binocular Functions in Myopic Children.Clinical optometry · 2025Article
- Effects of orthokeratology on corneal reshaping and the delaying of axial eye growth in children.Heliyon · 2024Article
- Pharmacologically Induced Accommodation Palsy and the Bioelectrical Activity of the Muscular System: A Preliminary Investigation.Diagnostics (Basel, Switzerland) · 2024Article
- Baseline Accommodation and Binocular Vision Measures in Malay Schoolchildren Enrolled in the Myopia Control Study Using Spectacle Lenses in Kuala Lumpur.Clinical optometry · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
Purpose: To investigate the ratio of accommodative convergence per diopter of accommodative response (AC/A ratio) before, during, and after myopia onset. Methods: Subjects were 698 children aged 6 to 14 years who became myopic and 430 emmetropic children participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error. Refractive error was measured using cycloplegic autorefraction, near work by parent survey, and the AC/A ratio by simultaneously monitoring convergence and accommodative response. The response AC/A ratios of children who became myopic were compared with age-, sex-, and ethnicity-matched model estimates for emmetropic children from 5 years before through 5 years after the onset of myopia. Results: The response AC/A ratio was not significantly different between the two groups 5 years before onset, then increased monotonically in children who became myopic until reaching a plateau at myopia onset of about 7 Δ/D compared to about 4 Δ/D for children who remained emmetropic (differences between groups significant at P < 0.01 from 4 years before onset through 5 years after onset). A higher AC/A ratio was associated with greater accommodative lag but not with the rate of myopia progression regardless of the level of near work. Conclusions: An increasing AC/A ratio is an early sign of becoming myopic, is related to greater accommodative lag, but does not affect the rate of myopia progression. The association with accommodative lag suggests that the AC/A ratio increase is from greater neural effort needed per diopter of accommodation rather than change in the accommodative convergence crosslink gain relationship.
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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.