Clinical Factors in Proximal Vergence

Using forced vergence fixation disparity curves, proximal vergence was analyzed in two asymptomatic patient samples; 20 young adults (average age 25.2 +/- 4.71 years) and 20 presbyopes (average age 61.6 +/- 7.8 years). Total proximal vergence was significantly larger when measured under binocular (closed loop) conditions than monocular (open loop) conditions for pre-presbyopes (binocular 10.51 delta +/- 4.7 vs. 6.4 delta +/- 3.84 monocular) and presbyopes (binocular 11.59 delta +/- 3.13 vs. 4.71 delta +/- 2.15 monocular). Associated proximal vergence was shown to predict associated phoria magnitude in presbyopes and in pre-presbyopes when vergence adaptation and convergence accommodation (CA/C) interactions with accommodative convergence (AC/A) are included. A vergence/accommodation model is presented which includes influences of proximal vergence. Clinical implications of the findings relating to diagnosis and therapy are discussed.