Accommodation Insufficiency (AI) is a condition in which a patient has an inability to focus or maintain focus at near. AI is mostly observed to occur with a vergence problem especially convergence insufficiency due to the close link between accommodation and convergence system of the eyes. Common symptoms seen in AI are diplopia, asthenopia and difficulty reading at near. Several management options are available including plus lenses for near work, optometric vision therapy and monitoring. A 17-year-old lady presented to the eye department with eyestrains, frontal headache, blurry vision at near with reading difficulties. According her, this problem started in 2018. Visual acuity (VA) for both distance and near was measured. Detailed anterior and posterior segments assessment revealed no anomalies, but binocular assessment showed reduced Amplitude of Accommodation (AOA), increased lag of accommodation, reduced Monocular Accommodative Facility (MAF) and Binocular Accommodative Facility (BAF), reduced Positive Relative Accommodation (PRA) and receded Near Point of Convergence (NPC). Based on the patient’s complaint and what the assessment revealed, accommodative insufficiency with vergence disorder was made. Vision therapy and distance optical correction were prescribed to manage the problem. Accommodative Insufficiency can be treated effectively by an in-office/home-based program. The repetition of appropriate optometric vision therapy procedures at home will help resolve a patient’s maladaptive visual condition over time.
| Published in | International Journal of Ophthalmology & Visual Science (Volume 5, Issue 1) |
| DOI | 10.11648/j.ijovs.20200501.12 |
| Page(s) | 11-14 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Accommodative Insufficiency, Accommodation, Binocular Vision, Convergence Insufficiency
| [1] | J. S. Cooper, et al, Care of the Patient with Accommodative and vergence Dysfunction, Lindbergh Blvd: American Optometric Association, 2011. |
| [2] | M. Scheiman and B. Wick, Clinical Management of Binocular Vision: Heterophoric, Accommodative and Eye Movement Disorders. 4th. New York: Wolters Kluwer, 2015. pp. 335-365. |
| [3] | Duam KM. Accommodative Dysfunction. Doc Ophthalmol 1983; 55: 177-98. |
| [4] | Hofstetter HW. Useful age-amplitude formula. Optom World 1950; 38: 42-5. |
| [5] | Eanes TH. “Low fusional convergence as a factor in reading disability”. American Journal of Ophthalomology 17. 8 (1934): 709-710. |
| [6] | W. J. Benjamin, etal Borish's Clinical Refraction. 2nd. Philadelphia: Butter-Heinmann, 2006. pp. 114-115. |
| [7] | Duke-Elder S. The practice of refraction, 5th ed. St. Louis: CV Mosby, 1987: 431-59. |
| [8] | Borsting E, Rouse MW, Deland PN, et al. Association of symptoms and convergence and accommodation in school-age children. Optometry. 2003; 74 (1): 25-34. |
| [9] | Marran LF, De Land PN, Nguyen AL. Accommodative insufficiency is the primary source of symptoms in children diagnosed with convergence insufficiency. Optom Vis Sci. 2006; 83 (5); 281-9. |
| [10] | Copper J, Jamal N. Comvergence insufficiency: a major review. Optometry. 2012; 83 (4): 137-58. |
| [11] | Shin HS, Park SC, Parh CM. Relationship between accommodative and vergence dysfunctions and academic achievement for primary school children. Ophthalmic Physiol Opt. 2009; 29 (6): 615-24. |
| [12] | Borsting E, Mitchell GL, Kulp MT, et al. Improvement in academic behaviors following successful treatment of Convergence insufficiency. Optom Vis Sci. 2012; 89 (1): 12-8. |
| [13] | Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders; Scheiman M, Wick B (Eds); Lippincott Williams & Wilkins, 2002. |
| [14] | AOA Optometric Clinical Practice Guideline; Care of the Patient with Accommodative and Vergence Dysfunction, 1998. |
| [15] | Daum KM. Accommodative Insufficiency. Am J Optom Physiol Opt 1983; 60 (5): 352-359. |
| [16] | Sterner B, Gellerstedt M, Sjo A. Accommodation and the relationship to subjective symptoms with near work for young school children. Ophthal Physiol Opt. 2006 26 (2): 148–155. |
APA Style
Emmanuel Kanyika, Bright Vandyke Okyere. (2020). A Case of Accommodative Insufficiency with Vergence Disorder in a 17-Year Old Student. International Journal of Ophthalmology & Visual Science, 5(1), 11-14. https://doi.org/10.11648/j.ijovs.20200501.12
ACS Style
Emmanuel Kanyika; Bright Vandyke Okyere. A Case of Accommodative Insufficiency with Vergence Disorder in a 17-Year Old Student. Int. J. Ophthalmol. Vis. Sci. 2020, 5(1), 11-14. doi: 10.11648/j.ijovs.20200501.12
AMA Style
Emmanuel Kanyika, Bright Vandyke Okyere. A Case of Accommodative Insufficiency with Vergence Disorder in a 17-Year Old Student. Int J Ophthalmol Vis Sci. 2020;5(1):11-14. doi: 10.11648/j.ijovs.20200501.12
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Download@article{10.11648/j.ijovs.20200501.12,
author = {Emmanuel Kanyika and Bright Vandyke Okyere},
title = {A Case of Accommodative Insufficiency with Vergence Disorder in a 17-Year Old Student},
journal = {International Journal of Ophthalmology & Visual Science},
volume = {5},
number = {1},
pages = {11-14},
doi = {10.11648/j.ijovs.20200501.12},
url = {https://doi.org/10.11648/j.ijovs.20200501.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20200501.12},
abstract = {Accommodation Insufficiency (AI) is a condition in which a patient has an inability to focus or maintain focus at near. AI is mostly observed to occur with a vergence problem especially convergence insufficiency due to the close link between accommodation and convergence system of the eyes. Common symptoms seen in AI are diplopia, asthenopia and difficulty reading at near. Several management options are available including plus lenses for near work, optometric vision therapy and monitoring. A 17-year-old lady presented to the eye department with eyestrains, frontal headache, blurry vision at near with reading difficulties. According her, this problem started in 2018. Visual acuity (VA) for both distance and near was measured. Detailed anterior and posterior segments assessment revealed no anomalies, but binocular assessment showed reduced Amplitude of Accommodation (AOA), increased lag of accommodation, reduced Monocular Accommodative Facility (MAF) and Binocular Accommodative Facility (BAF), reduced Positive Relative Accommodation (PRA) and receded Near Point of Convergence (NPC). Based on the patient’s complaint and what the assessment revealed, accommodative insufficiency with vergence disorder was made. Vision therapy and distance optical correction were prescribed to manage the problem. Accommodative Insufficiency can be treated effectively by an in-office/home-based program. The repetition of appropriate optometric vision therapy procedures at home will help resolve a patient’s maladaptive visual condition over time.},
year = {2020}
}
TY - JOUR T1 - A Case of Accommodative Insufficiency with Vergence Disorder in a 17-Year Old Student AU - Emmanuel Kanyika AU - Bright Vandyke Okyere Y1 - 2020/01/07 PY - 2020 N1 - https://doi.org/10.11648/j.ijovs.20200501.12 DO - 10.11648/j.ijovs.20200501.12 T2 - International Journal of Ophthalmology & Visual Science JF - International Journal of Ophthalmology & Visual Science JO - International Journal of Ophthalmology & Visual Science SP - 11 EP - 14 PB - Science Publishing Group SN - 2637-3858 UR - https://doi.org/10.11648/j.ijovs.20200501.12 AB - Accommodation Insufficiency (AI) is a condition in which a patient has an inability to focus or maintain focus at near. AI is mostly observed to occur with a vergence problem especially convergence insufficiency due to the close link between accommodation and convergence system of the eyes. Common symptoms seen in AI are diplopia, asthenopia and difficulty reading at near. Several management options are available including plus lenses for near work, optometric vision therapy and monitoring. A 17-year-old lady presented to the eye department with eyestrains, frontal headache, blurry vision at near with reading difficulties. According her, this problem started in 2018. Visual acuity (VA) for both distance and near was measured. Detailed anterior and posterior segments assessment revealed no anomalies, but binocular assessment showed reduced Amplitude of Accommodation (AOA), increased lag of accommodation, reduced Monocular Accommodative Facility (MAF) and Binocular Accommodative Facility (BAF), reduced Positive Relative Accommodation (PRA) and receded Near Point of Convergence (NPC). Based on the patient’s complaint and what the assessment revealed, accommodative insufficiency with vergence disorder was made. Vision therapy and distance optical correction were prescribed to manage the problem. Accommodative Insufficiency can be treated effectively by an in-office/home-based program. The repetition of appropriate optometric vision therapy procedures at home will help resolve a patient’s maladaptive visual condition over time. VL - 5 IS - 1 ER -
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