A recent study in Cell Reports reports that myopia may be associated not only with sensory retinal deficits but also with abnormal visuomotor responses during accommodation.
The investigators examined how the ON and OFF retinal pathways contribute to accommodation-driven vergence and pupil responses. Using an electrically tunable lens to induce −5.00 D of optical defocus in one eye, participants increased crystalline lens power to refocus a small target. This accommodation triggered bilateral pupil constriction and inward vergence of the occluded eye, allowing measurement of accommodative eye vergence.
Compared with non-myopic individuals, myopic participants demonstrated excessive accommodative eye vergence, reduced ON pathway dominance, and excessive accommodative pupil constriction.
The authors propose that exaggerated accommodative miosis reduces retinal illumination, potentially weakening ON pathway signalling. This mechanism may help explain why myopia progression is associated with activities that maximise accommodative pupil constriction (e.g. sustained near work in dim light) and mitigated by interventions that reduce it, including outdoor exposure, low-dose atropine and positive defocus.
→ Read the full article here
Reference: Maharjan U, Rahimi-Nasrabadi H, Poudel S, et al. Human accommodative visuomotor function is driven by contrast through ON and OFF pathways and is enhanced in myopic. Cell Reports. 2026;45:116938.
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Citation: Accommodative miosis and ON pathway deficits linked to myopia. touchOPHTHALMOLOGY. 27 February 2026.
Disclosure: This article was created by the touchOPHTHALMOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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