![]() Interestingly, even though the same neural machinery is involved in both the accommodation reflex and the pupillary light reflex, certain conditions demonstrate a dissociation between the two pathways this is called light-near dissociation. In afferent pupillary defects as in optic nerve lesions, the pupil does not react to light reflex, but near reflex will be present. Vision is not a prerequisite for accommodation reflex. Since parasympathetic fibers of the oculomotor nerve mediate ciliary contraction and pupillary constriction, parasympatholytics like atropine results in loss of accommodation and parasympathomimetics like pilocarpine induce accommodation. Given the synkinesis required to coordinate near vision properly, any pathology that hinders convergence, ciliary contraction, or pupillary constriction can disrupt the reflex.
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