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.
