Korean J Ophthalmol.  2013 Apr;27(2):116-119. 10.3341/kjo.2013.27.2.116.

Long-term Follow-up of Acute Isolated Accommodation Insufficiency

• Lee JJ
• Baek SH
• Kim US

• KMID: 1503803
• DOI: http://doi.org/10.3341/kjo.2013.27.2.116

Abstract

PURPOSE
To define the long-term results of accommodation insufficiency and to investigate the correlation between accommodation insufficiency and other factors including near point of convergence (NPC), age, and refractive errors.
METHODS
From January 2008 to December 2009, 11 patients with acute near vision disturbance and remote near point of accommodation (NPA) were evaluated. Full ophthalmologic examinations, including best corrected visual acuity, manifest refraction and prism cover tests were performed. Accommodation ability was measured by NPA using the push-up method. We compared accommodation insufficiency and factors including age, refractive errors and NPC. We also investigated the recovery from loss of accommodation in patients.
RESULTS
Mean age of patients was 20 years (range, 9 to 34 years). Five of the 11 patients were female. Mean refractive error was -0.6 diopters (range, -3.5 to +0.25 diopters) and 8 of 11 patients (73%) had emmetropia (+0.50 to -0.50 diopters). No abnormalities were found in brain imaging tests. Refractive errors were not correlated with NPA or NPC (rho = 0.148, p = 0.511; rho = 0.319, p = 0.339; respectively). The correlation between age and NPA was not significant (rho = -395, p = 0.069). However, the correlation between age and NPC was negative (rho = -0.508, p = 0.016). Three of 11 patients were lost to follow-up, and 6 of 8 patients had permanent insufficiency of accommodation.
CONCLUSIONS
Accommodation insufficiency is most common in emmetropia, however, refractive errors and age are not correlated with accommodation insufficiency. Dysfunction of accommodation can be permanent in the isolated accommodation insufficiency.

Keyword

Accommodation; Convergence; Diplopia

MeSH Terms

*Accommodation, Ocular
Acute Disease
Adolescent
Adult
Child
*Convergence, Ocular
Diplopia/*etiology/pathology
Female
Follow-Up Studies
Humans
Male
Ocular Motility Disorders/*complications/pathology
Refractive Errors/*complications/pathology
Retrospective Studies
Young Adult

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