Accommodative dysfunction is caused by a focusing problem. This is not an eyesight (or clarity) difficulty as per say, it is more of a problem in maintaining accurate, comfortable focus, especially while working close. Accommodative dysfunction is more common in children.
Why do children develop this condition?
Generally, a focusing problem is not not related to muscular issues. At time, children can fail to form sufficient focusing stamina, during early childhood. However, in the majority of cases focusing dysfunction problems are due to fatigue. This can be a result of persistent long term near visual tasks including reading, writing, computer, games etc. So we can say this is more of an acquired problem rather than something being innately wrong with your child’s visual system. 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 to look for
The symptoms associated with focusing dysfunction usually occur during or soon after the task in question. 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).
You should always plan to have your child’s regular eye exam once a year. This way you will be able to give them help they need to succeed at school as soon as possible. However if you have not had an eye exam in a while and you notice any of these symptoms, book an eye exam with your optometrist right a way. Remember, eye exam under the age of 19 are covered by OHIP.
Are there any treatments?
Part of the treatment requires the prescribing of spectacle lenses for close work. In many cases this is all that is required. However, for some focusing disorders, visual therapy is also required. Visual therapy on its own does not work well to alleviate these problems. Therapy teaches better control but does not relieve the fatigue component. If vision therapy is required it usually requires a series of in-office visits along with home based therapy between these visits, which are usually one to two weeks apart. Treatment duration will 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.
What about the Future?
Generally your child will be required to wear eyeglasses for at least 12 to 36 months. As this problem occurs due to the stresses placed on the visual system with prolonged near work, the support of eyeglasses may still be required for exam times, prolonged reading times, reading when tired or ill etc, even beyond the 36 months. Children who have reading glasses do not become dependent on them and do not get worse through the use of spectacles. Ultimately it is expected that most children are weaned out of their glasses. Some children with these problems never improve sufficiently to stop wearing their glasses for reading completely. Your child should have regular eye exams their schooling life as the demands of the classroom change throughout the school years, and it is important to get help as soon as possible.