# Afferent and Efferent Visual Systems During Abnormal Vision Development

> **NIH NIH R01** · STANFORD UNIVERSITY · 2023 · $607,892

## Abstract

PROJECT SUMMARY/ABSTRACT
Approximately 3% percent of infants and children 6 to <72 months have strabismus or amblyopia. The
development of amblyopia and strabismus are proposed to be the result of abnormal visual experience. Normal
visual experience depends on both good retinal image quality and eye alignment, which require complex
interactions between the afferent and efferent visual systems. Understanding these interactions are critical to
both the development of preventive measures and the accumulation of evidence-based treatment strategies for
strabismus and amblyopia. Hyperopic infants who do not emmetropize are at risk for developing strabismus and
amblyopia with as little as 2D spherical equivalent (SE), and that risk increases exponentially with every added
diopter of uncorrected hyperopia. Moreover, the infants who are less likely to emmetropize, are the ones who do
not accommodate well to a near stimulus.
Specific Aim 1: To test the hypothesis that there is a deficit in or immaturity of the afferent visual system that
causes poor blur detection which subsequently results in a decreased efferent accommodative response. We
will examine retinal blur detection in infants with typical refractive error and with moderate/high hyperopia
longitudinally at 3- and 9-months of age.
Specific Aim 2: To test the hypothesis that the tonic adaptive components of accommodation are the primary
factors responsible for the manifestation of accommodative esotropia in young children with clinically significant
hyperopia. We will measure the phasic response and tonic adaptive components of the adult oculomotor control
model in children ages 2 to <6 years with moderate/high hyperopia, including some with accommodative
esotropia prior to refractive error correction.
Long term Goal: Provide pediatric vision care practitioners with the ability to identify: [a] which infants with
hyperopia will emmetropize and which will not and [b] of the infants who do not emmetropize, which ones will go
on to develop strabismus and amblyopia. Improved ability to identify infants at highest risk will lead to improved
patient outcomes.

## Key facts

- **NIH application ID:** 10540366
- **Project number:** 5R01EY029307-04
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Tawna Roberts
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $607,892
- **Award type:** 5
- **Project period:** 2020-04-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10540366

## Citation

> US National Institutes of Health, RePORTER application 10540366, Afferent and Efferent Visual Systems During Abnormal Vision Development (5R01EY029307-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10540366. Licensed CC0.

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