Effect of lag of accommodation and proximal convergence

Clinically we test only the stimulus accommodation and assume them to same as the response accommodation. But because of depth of focus it doesnt have to be the same According to Sheards for most ammetropes the accommodational responses tend to be less than stimulus , Lag of accommodation. As the result the ac/a ratio that is derived clinically is not equal to the response AC/A(we measure the stimulus ACA ratio)

 This could be avoided by asking the patient to keep the wording clear with his bcva in place. A lag of accommodation that is variable or that increases with the stimulus to accommodation can be detected by the notching a phoria line that is less slanted towards y axis.(indicating lower ACA ratio)

 Higher the lag of accommodation at the higher stimulus to accommodation ,lower will the AC/A ratio giving a appearance of false.

Proximal convergence
Convergence caused by the awareness of the closeness of the object . Subject with high proximal convergence have the zone with fanned