IMI Accommodation and Binocular Vision in Myopia Development and Progression

Nicola S Logan, Hema Radhakrishnan, Fiona E Cruickshank, Peter M Allen, Praveen K Bandela, Leon N Davies, Satoshi Hasebe, Safal Khanal, Katrina L Schmid, Fuensanta A Vera-Diaz, James S Wolffsohn

Research output: Contribution to journalReview articlepeer-review


The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.

Original languageEnglish
Article number4
Number of pages21
JournalInvestigative Ophthalmology and Visual Science
Issue number5
Publication statusPublished - 28 Apr 2021

Bibliographical note

Copyright 2021 The Authors. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.


  • Accommodation
  • Binocular vision
  • Emmetropization
  • Myopia development
  • Myopia progression


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