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Accommodative Insufficiency: A Literature and Record Review

Author(s): Mary Bartuccio, OD, FAAO | Marc B. Taub, OD, FAAO | Jennifer Kieser, BS

Journal: Optometry & Vision Development
ISSN 1557-4113

Volume: 39;
Issue: 1;
Start page: 35;
Date: 2008;
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Keywords: accommodation | accommodative insufficiency | optometric vision therapy | near plus add | bifocal

ABSTRACTBackground: Accommodative Insufficiency (AI)is a condition in which a patient has an inability tofocus or sustain focus at near. Several managementoptions are available including plus lenses for near,optometric vision therapy, and monitoring.Methods: A database of patients evaluated at theNova Southeastern University Eye Institute between1/03 and 6/04 diagnosed with accommodativedysfunction was reviewed. A total of 504 charts wereidentified via an electronic database search. A manualchart review was performed of the identified charts.Results: Fifty-four cases met the eligibility criteriafor AI as defined in this paper. Myopia (56%) was mostcommonly found refractive condition in this groupfollowed by emmetropia (37%), and hyperopia (7%).The most frequently encountered chief complaint wasdistance blur (n=20 subjects) followed by headaches(n=8), both distance and near blur (n=7) and nearvision blur only (n=5). Optometric vision therapy wasprescribed in 27.8 % of the cases, while plus at nearwas given in 74% of the cases. Of 40 patients issuedplus at near, bifocals (40.7%) were most commonlyprescribed, followed by reading glasses (29.6%) andprogressive addition lenses (3.7%).Conclusions: This study finds that the mostcommon treatment of accommodative insufficiencyin an academic health center is prescribing a near addition power lens. This article discusses the results ofthe record review, as well as the definition, diagnosis,and treatment of accommodative insufficiency.

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