Objective:To compare the real-time accommodative response and accommodative microfluctuations during sustained reading/viewing of rapid serial visual presentations (RSVP) and different target presentations.Methods:This was a prospective study. A total of 33 subjects aged from 15 to 28 years were included at Eye Hospital, Wenzhou Medical University from April to October in 2019. The mean age ofthe subjects was 22.1±4.8 years and the mean spherical equivalent was-3.81±1.67 D. Accommodative response and micro?uctuations were measured using the Grand Seiko WAM-5500 auto-refractor while the subject was continuously tested with different targets for 5 minutes. The targets were as follows: RSVP (a rapid serial visual presentation paradigm), Rand-RSVP (a random word rapid serial visual presentation paradigm), Maltese Cross (a target with a Maltese cross) and Windows Text (a window of reading material for 5 minutes). The accommodative response and microfluctuations for different types of visual targets were compared. One-way ANOVA was used to compare the differences in accommodation while reading or viewing the different visual targets. A pairedt-test was used to compare the difference between the initial 10-second measurement and 5-minute accommodative response.Results:While viewing the Maltese Cross, all subjects had a lower mean accommodative response (t=2.45,P=0.016;t=2.57,P=0.011;t=3.85,P<0.001) and a larger accommodative variability (t=4.32,P<0.001;t=1.86,P=0.065;t=2.93,P=0.04).Power spectrum analysis showed that subjects exhibited greater power at low temporal frequencies while viewing the Maltese Cross (t=30.32,P<0.001), and more power at medium and high temporal frequencies when reading the Window Text (t=32.41,P<0.001;t=38.26,P<0.001). Subjects had a higher accommodative response in the ?rst 10 seconds than the averageaccommodative response within 5 minutes when reading/viewing RSVP, random RSVP and Maltese Cross (t=2.30,P=0.028;t=2.45,P=0.020;t=3.71,P=0.001).Conclusions:Different presentation paradigms produce different accommodative responses and micro?uctuations. Accommodative response in the early stage varied after sustained reading/viewing during continuous testing.