Gender differences in early accommodation and vergence development

Horwood,A Riddell,P. Ophthalmic & Physiological Optics 2008, 28, 115-126

• Accommodation matured slightly earlier in males than females
• Females may show earlier preference for disparity cues

A remote haploscopic photorefractor was used to assess objective binocular vergence and accommodation responses in 157 full term healthy infants aged 1-6 months while fixating a brightly coloured target moving between fixation distances at 2m, 1m, 0.5m and 0.33m. Vergence and accommodation response gain matured rapidly from “flat” neonatal responses at an intercept of approximately 2 dioptres (D) for accommodation and 2.5 metre angles(MA) for vergence , reaching adult-like values at 4 months. Vergence gain was marginally higher in females (p=0.064), but accommodation gain (p=0.034) was higher and accommodative intercept closer to zero (p=0.004) in males in the first three months as they relaxed accommodation more appropriately for distant targets. More females showed flat accommodation responses (p=0.029). More males behaved hypermetropically in the first two months of life, but these hypermetropic infants were excluded from the analysis, the effect remained. Gender differences disappeared after three months. Data showed variable responses and infants could behave appropriately and simultaneously on both, neither or only one measure at all ages. If accommodation was appropriate (gain >0.7<1.3 & r2 >0.7) but vergence was not, males over- and under-converged equally, while the females who accommodated appropriately were more likely to overconverge(p=0.008). The apparent earlier maturity of the male accommodative responses may be due to refractive error differences but could also reflect gender-specific male preference for blur cues while females show earlier preference for disparity, which may underpin earlier emerging, disparity dependent, stereopsis and full vergence found in females found by others.