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A-Z Glossary

Table of Contents

Accommodation Disorder

Vasudha Rao
Written byVasudha Rao
  • Last updated January 13, 2023

What is Accommodation Disorder?

Accommodation disorder, also known as accommodative dysfunction, is any problem with the focusing power of the eye. The condition might result in blurred vision or trouble switching focus. There are many different types of accommodation disorders that can happen to the eyes. Accommodation disorders can happen in people of any age. The most common accommodation disorder is accommodative insufficiency, or a weak focusing system. The most common treatment option for accommodative disorders are prescription reading glasses. However, other treatment options such as vision therapy or prism glasses may also be recommended. 

Key Takeaways

  • Accommodation disorders occur when the eyes are not able to focus properly on distant or near objects.
  • There are four major accommodation disorders: accommodative insufficiency, accommodative spasm, accommodative infacility, and ill-sustained accommodation.
  • The most common symptom of accommodative disorders is blurry vision, especially when reading. 
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Understanding Accommodation Disorder

Accommodation is also known as the focusing power of the eye. We need accommodation in order to make the vision clear at different distances. The eye uses more focusing power when viewing objects up close. For example, the eye needs lots of accommodation in order to focus on small text when reading books. The eye only needs a small amount of accommodation to make the vision clear at distance, such as when driving or watching TV. If the eye is unable to focus properly, it’s known as an accommodation disorder.

Accommodation is performed by the lens and ciliary muscles inside of the eye. The lens moves forward and becomes thicker when it’s focusing on near objects. When looking far away, the lens moves backwards and becomes thinner. A normal, healthy eye can easily adjust its focusing strength to dial in different amounts of accommodation, depending on how the eye is being used. However, some people have dysfunctional accommodation.

Types Of Accommodation Disorder

 There are four  types of accommodation disorders: 

  1. Accommodative Insufficiency
    This condition involves a weak focusing system. People with accommodative insufficiency do not have enough focusing power to see at near clearly. It is the most common type of accommodation disorder. The most common symptom of accommodation insufficiency is blurry near vision when reading, because the eyes cannot focus properly. 
  2. Accommodative Infacility
    This type of disorder involves difficulty in switching focus between near and far objects. For example, someone may notice that their vision is blurry when they look up after using the computer for a while. The eye cannot swiftly change focus between different distances. The vision will be momentarily blurry when changing focus. 
  3. Accommodative Spasm
    This disorder is also known as accommodative excess. People with accommodative spasm have too much accommodation. They cannot easily relax their focusing power. This can make the distance vision blurry. 
  4. Ill-Sustained Accommodation
    This condition occurs when the eyes get tired of focusing over time. After a while of doing near work like reading, the vision will become blurry. People with this condition have a normal amount of focusing power at first, but it decreases over minutes to hours of being used. 

Symptoms Of Accommodation Disorder

The symptoms of accommodation disorders vary based on which type of accommodative disorder an individual has. 

Accommodative Insufficiency:

  • Blur when reading at near
  • Vision becomes blurry after a few hours of reading
  • Headaches when reading at near
  • Eye strain when reading
  • Reduced reading comprehension
  • Holding reading material far away to make it clear

Accommodative Infacility:

  • Blur when adjusting focus
  • Transient blurred vision after switching from looking far away to near, or vice-versa 
  • Difficulty multitasking if tasks are at different distances

Accommodative Spasm:

  • Blur at distance
  • Blur after prolonged near work

Ill-sustained Accommodation:

  • Unable to read for long periods
  • Eyes get tired after reading 
  • Need frequent breaks to finish homework or reading books

Treatment 

Reading Glasses 

The most common treatment for all accommodative disorders are reading glasses. The natural focusing power of the eye can be supplemented with artificial focusing power through a reading eyeglasses prescription. Reading glasses are a quick fix that can immediately make the near vision more clear and reduce headaches or eye strain.

Vision Therapy

Another treatment option is vision therapy, also known as eye exercises. Certain eye exercises can make the focusing system stronger. These activities are done in the doctor’s office or at home to strengthen the focusing system. For example, with pencil push-ups, the eyes are trained to focus on a pencil by bringing it close to the eyes. The eye exercises typically have to be done for a period of 3 months in order to see results.

Prism Glasses

Prism is an optical feature that can be added into the lenses of the eyeglasses. Prism bends light to match the natural resting eye posture. Some people have eye turns or abnormal eye positioning that can contribute to accommodative disorders. Adding prism to the glasses prescription may make the vision more comfortable and resolve the accommodative problem.

Sources

  1. “Accommodation Disorder – an Overview | ScienceDirect Topics.” Www.sciencedirect.com, www.sciencedirect.com/topics/medicine-and-dentistry/accommodation-disorder. Accessed 5 Aug. 2022.
  2. Chase, Christopher, et al. “Using Accommodative Lag to Diagnose Accommodation Disorders.” Clinicaltrials.gov, 23 Dec. 2014, www.clinicaltrials.gov/ct2/show/NCT01329848. Accessed 5 Aug. 2022.
  3. Hussaindeen, Jameel Rizwana, and Amirthaa Murali. “Accommodative Insufficiency: Prevalence, Impact and Treatment Options.” Clinical Optometry, vol. Volume 12, Sept. 2020, pp. 135–149, 10.2147/opto.s224216.

 

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