Accommodative dysfunction is commonly encountered in paediatric eye care meaning children are affected the most with accommodative insufficiency and accommodative infacility being the most common ones. Some children may not be able to complete reading task or assignments and may be easily distracted or be inattentive in class as a result of accommodative dysfunctions. Click here to read the first article on Accomodative Dysfunction.
COMMON SIGNS, SYMPTOMS, AND COMPLICATIONS
Accommodative insufficiency. Patients with accommodative insufficiency will usually complain of
• blurred vision
• difficulty reading
• irritability
• poor concentration
• Headaches
Accommodative spasm. Patients with this condition will report to clinic with
• Blurred vision
• Fluctuating vision
• Headache
• Eye fatigue
• Loss of concentration
Ill-sustained accommodation. The most common sign or symptom of ill-sustained accommodation is
• blurred vision after prolonged near work.
Accommodative infacility. Patients with accommodative infacility report
• blurred distance vision after prolonged near work and vice versa.
Paralysis of accommodation in this case the patient reports
• blur due to failure to accommodate.
MANAGEMENT STRATEGY FOR ACCOMMODATIVE DYSFUNCTION
• Accommodative Insufficiency
The most effective treatment for accommodative dysfunction is vision therapy to build amplitude of accommodation and accommodative facility. Therapy should focus on increasing accommodative amplitudes. Alternatively, plus lenses may be prescribed at near if the patient is not able to meet the time requirements for vision therapy.
• Ill-Sustained Accommodation
Plus lenses and vision therapy are effective in treating ill-sustained accommodation. Vision therapy is used to improve the speed of the accommodative response and its mostly the preferred treatment option.
• Accommodative Infacility
Plus lenses may be prescribed initially, but vision therapy is highly effective in correcting accommodative infacility. The goal of therapy is to improve the speed and flexibility of accommodation.
• Paralysis of Accommodation
The treatment of paralysis of accommodation is directed at determining its underlying cause and correcting it when necessary. Paralysis of accommodation may be treated with a progressive addition lens in front of the affected eye. Vision therapy is not effective in treating this condition.
• Spasm of Accommodation
The initial treatment of spasm of accommodation consists of plus lenses but in most cases, lenses alone are not sufficient to eliminate an accommodative spasm. The clinician should also prescribe vision therapy to relax accommodation. If vision therapy fails, short-term use of a cycloplegic agent may be prescribed. The ultimate goal is elimination of the spasm (and the need for cycloplegia and/or plus lenses). In addition to these treatments, the clinician should reinforce the importance of visual hygiene in the form of proper working distance, lighting, and appropriate rest periods.
REFERENCES
• American Optometric Association (2001). Optometric Clinical Practice Guideline, Care of the Patient with Accommodative and Vergence Dysfunction
• Cline D, Hofstetter HW, Griffin JR. Dictionary of visual science, 4th ed. Radnor, PA: Chilton, 1989.
• Grosvenor TP. Primary care optometry. Anomalies of refraction and binocular vision, 3rd ed. Boston: Butterworth-Heinemann, 1996
• Scheiman, M. and Wick, B. (2002). Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders. 2nd edition, Philadelphia; Lippincott Williams and Wilkins.
• Journal of Science and Technology, Vol. 34, No. 2 (2014) Department of Optometry and Visual Sciences KNUST, Kumasi
What is @bettervision about?
@bettervision is is a project initiated by @nattybongo and friends to give back to the society the knowledge and skill acquired through the Optometric Studies in Kwame Nkrumah University of Science and Technology, Ghana.It is an outreach system where we visit the less privileged communities to offer free eye screening services and education to the people within the community
AIMS AND OBJECTIVES
To reduce or prevent vision loss through diseases such as glaucoma, cataract and refractive errors.
To enlighten the majority of the Ghanaian population about the importance of proper visual care.
To conscientize people on the need for regular eye checks
To get more people to have their wards screened within the Critical periods of a Child’s Vision Development; thus from ages 3 to till about 10 years.
To help the blind and people with low vision live a better life within the society through education of the general public to stop stigmatization.
To help in the fight of extreme poverty that puts the health of people at risk
Our greatest gratitude goes to @fundition @adollaraday @surfyogi @girlsfoundation @bleepcoin @ackza @indigoocean @nanzo-scoop @steemstem @demotruk @pennsif @steem-ambassador @kasho and @wafrica for helping to make the aims and objectives of @bettervision a reality.
