We studied accommodation and vergence eye movements in a patient with a left middle cerebral artery embolism. Accommodation was monitored by an infrared optometer with the accommodative target being controlled by a microcomputer. Computed tomography showed low-density areas in the left cortex, with intact brainstem. The patient had convergence palsy and accommodation abnormalities. The amplitude of the accommodative responses was reduced and the accommodation velocity was markedly lowered. Our results further substantiate the neurologic relationship between the cerebral cortex and accommodation and convergence.