Accommodative Dysfunction

Accommodative dysfunction is a problem with the focusing system of the eye, particularly at near.

You may be able to see clearly in general but have difficulty maintaining accurate, comfortable focus particularly with near work.

Focusing problems generally are not muscle problems. Occasionally, a child can fail to establish adequate focusing stamina during their early years of development, but in the vast majority of cases focusing dysfunction problems arise from fatigue as a result of sustained near visual tasks such as reading, writing, and computer. Prolonged near tasks can be fatiguing to certain individuals. The visual effort required to try to cope with this task can sometimes cause a breakdown in the visual system leading to focusing dysfunction. This can even happen in the adult eye, especially if we are tired, run down or ill, or have commenced a new task with a lot of near work.

WHAT ARE THE SYMPTOMS?

The symptoms associated with focusing dysfunction usually occur during or soon after close work. The symptoms may include, but are not limited to the following:

  • Visual discomfort, such as red or sore eyes, transient distance and/or near blur and headaches (usually frontal or temporal).
  • Difficulty sustaining near visual attention. This may result in avoidance of the tasks that produce visual stress.
  • Glare sensitivity or dizziness.
  • Rapid fatigue, even with a small amount of close work.
  • Abnormal posture adaptations such as head tilt or pulling the work away (some will pull their work closer).

TREATMENT

Part of the treatment requires the prescribing of spectacle lenses for close work to relieve the fatigue. In many cases this is all that is required. However, for some focusing disorders, vision therapy is also required. If vision therapy is recommended it usually consists of six in-office visits spaced one week apart, along with home based therapy between these visits. Treatment duration will vary and depend on the particular patient’s condition.

Visual hygiene must also be considered. Regular breaks from near tasks as well as a good working distance (generally elbow-to-fist) from reading or writing material is important.

Generally your child will be required to wear glasses for at least a couple of years. As this problem occurs due to the stress placed on the visual system with prolonged near work, the support of glasses may be required throughout most of their schooling years. Children who have reading glasses do not become dependent on them and do not get worse through the use of glasses. Annual vision examinations will ensure that your child is not wearing spectacles unnecessarily and that they are coping with the demands of increased workloads in higher grades.