S B Sterner
Clinical Neuroscience, Ophthalmology, Mölndal, Sweden
Background: Many visually impaired children may also suffer from accommodative dysfunctions. These dysfunctions can be difficult to identify becouse an accommodative dysfunction can in some cases be hidden in an incorrect interpretation of the eye disease and associated symptoms. Purpose: The purpose of the present work is therefore to characterize accommodative facility problems and related symptoms among otherwise healthy young pre-presbyopes showing accommodative dysfunction. The purpose is also to evaluate an accommodative facility training technique by studying the effect of the training on relative accommodation. It is important to outline the results of the training technique before conclusions can be drawn about using the technique on visually impaired pre-presbyopes with accommodative dysfunction. Subjects and methods: Children aged 9-13 years, referred by School Health Care for near work-related problems and complaining of headaches, blurred vision, asthenopia, loss of concentration, and avoidance of near activity, were selected. Only children with reduced negative relative accommodation (NRA) and positive relative accommodation (PRA) and/or very slow accommodative facility were included. For accommodative facility training, the subjects used an accommodative facility training technique until they reported that the symptoms had disappeared. Results: In all children, the symptoms gradually decreased and finally disappeared during the training period. Despite some individual variations, our data show a significant increase in both mean NRA and mean PRA among all children characterized with accommodative infacility due to an impaired relative accommodation. Discussion: The results indicate that accommodative facility training is an effective method resulting in loss of symptoms and that it also has a real effect on the amplitude of relative accommodation in patients with impaired relative accommodation.
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