Accommodative Insufficiency: A Literature and Record Review

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.