What is Accommodation? What is Accommodative Dysfunction? 

Accommodation is the ability of the eyes to focus on near targets. Accommodation occurs by movement of the lens inside the eye. This movement is controlled by muscles that generally relax to see far away and contract to see clearly at near. This mechanism is separate from “refractive error” or the need for glasses at distance; however, uncorrected refractive error can influence this system.

Accommodative ability is generally well developed by 4 months of age and should continue to work efficiently until around age 40, when the lens begins to become less flexible and therefore harder to move. This is why the majority of older adults require reading glasses or bifocals as they get older. 

Accommodative Dysfunction is the inability of the eyes’ focusing system to work properly.

What are the different types of Accommodative Dysfunction?

The different types of Accommodative Dysfunction are Accommodative Insufficiency, Accommodative Infacility, Ill-Sustained Accommodation, Accommodative Paralysis, and 

ACCOMMODATIVE INSUFFICIENCY

Accommodative Insufficiency causes a difficulty with efficiently sustaining focus at near. This is the most common type of accommodative dysfunction. The increased effort required to maintain clear vision at near can decrease performance on near tasks.

ILL-SUSTAINED ACCOMMODATION

Ill-Sustained Accommodation occurs when accommodation is normal but fatigue happens over time with repeated accommodative stimulus.

ACCOMMODATIVE PARALYSIS 

Accommodative Paralysis occurs when the accommodative system fails to respond to any stimulus. It can be caused by the use of cycloplegic drugs, or by trauma, ocular or systemic disease, toxicity, or poisoning.

ACCOMMODATIVE INFACILITY

Accommodative Infacility causes difficulty with efficiently switching focus between near and far and vice versa.

ACCOMMODATIVE SPASM

Accommodative Spasm causes a spasm of the focusing muscle which prevents the focusing muscles from fully relaxing. This generally causes blurry vision both near and far.

How is Accommodative Dysfunction diagnosed?

Dr. David Antonyan, the chief optometrist of Vivid Visions Optometry, Inc uses the latest equipment to thoroughly evaluate and diagnose the exact type of Accommodative Dysfunction you may have. 

In addition to Comprehensive Eye Examination, a Comprehensive Binocular Vision Evaluation is needed to accurately diagnose Accommodative Dysfunctions.

How is Accommodative Dysfunction treated?

Accommodative Dysfunctions are treated with special lenses and/or vision therapy. 

After conducting a Comprehensive Binocular Vision Evaluation, special lenses may be prescribed to reduce your eye strain. You may also need personalized vision therapy. 

At our clinic, treatment of accommodative dysfunctions with optometric vision therapy has a very high success rate (greater than 90%) and often requires between 12 to 24 sessions, when combined with home support activities. Patients with additional visual diagnoses, autism, developmental delay or a history of traumatic brain injury/concussion may require a longer treatment plan.