A review of non-strabismic accommodative and vergence anomalies in school-age children. Part 2: Accommodative anomalies

Samuel O Wajuihian,Rekha Hansraj

doi:10.4102/aveh.v74i1.33

Abstract

Comfortable reading and the performance of related near point activities involve efficient accommodative and vergence systems. However, accommodative and convergence anomalies are associated with various symptoms of asthenopia that impair efficient near point tasks. In Part 1 of this two-part article, studies on vergence anomalies were reviewed. In the current paper (Part 2), anomalies of accommodation are reviewed. The aims of the latter paper were to derive the prevalence and distribution estimates of anomalies of accommodation in school-age children and address variations in the study methods and findings. Despite variations in the study methods and findings, anomalies of accommodation are prevalent among school-age populations. Variations and limitations of previous studies are discussed and recommendations for improving future studies are suggested.

Highlights

Irrespective of whether single or multiple clinical signs are used to classify accommodative anomalies, the present review revealed that these anomalies are prevalent in all settings in school-age populations (Tables 2–5)
The present review has provided a workable prevalence range for accommodative anomalies and highlighted some methodological concerns in previous studies
Given that treatment regimens are based on appropriate measurement and diagnosis, it is important to establish a standardised worldwide diagnostic protocol and criteria with the ultimate goal of optimum patient care

Summary

Introduction

Accommodative and vergence binocular anomalies are vision disorders that affect clarity and binocularity, and impair comfort and efficiency of visual performance of an individual when near tasks such as reading, writing and computer-based works are performed.[1,2,3,4,5] For the school-age child, especially the high school learner, symptoms associated with accommodative-vergence anomalies tend to increase as the child advances through school;[1,2,3,4,5] this is because there is a greater demand at higher grade levels on the accommodative and vergence system for sustained clear vision owing to prolonged reading and increased information processing.[1,2,3,4,5] In Part 1, studies on vergence anomalies in school-age children were reviewed. In the current paper (Part 2), anomalies of accommodation are reviewed

Methods

Discussion

Conclusion