Accommodation is a unique mechanism by which our eyes focus the diverging rays from a near object on to retina to get a clear image. Facility of accommodation is the ability to alter accommodation rapidly and accurately at various distant. It is measured by inducing and relaxing accommodation with the help of accommodative flippers.
Near Point of Accommodation (NPA): It is the closest point at which small objects are seen clearly. NPA recedes with age. It is measured in centimetres and converted to dioptres (amplitude of accommodation).
Accommodative Insufficiency: When the accommodative power is significantly less than the normal physiological limits for the patient’s age, he or she is diagnosed as having accommodative insufficiency. It is caused by ciliary muscle weakness. It causes blurred near vision, discomfort & strain associated with near tasks, fatigue, difficulty with attention and concentration while reading. Accommodative insufficiency can be improved by a set of Orthoptic exercises uniquely designed by BYNOCS. These exercises have shown 80-90% improvements in the patients’ symptoms.
Ill-Sustained Accommodation is a condition in which the AA is normal, but patients get symptoms of fatigue with repeated accommodative stimulation.
Accommodative Infacility occurs when the accommodative system is slow in making a change, or when there is a considerable lag between the stimulus to accommodation and the accommodative response. The patient often reports blurred distance vision immediately following sustained near work. Some have considered this infacility to be a precursor to myopia.
Paralysis of Accommodation is a rare condition in which the accommodative system fails to respond to any stimulus. It can be caused by the use of cycloplegic drugs, or by trauma, ocular or systemic disease, toxicity, or poisoning. The condition, which can be unilateral or bilateral, may be associated with a fixed, dilated pupil. Treatment is directed to the cause.
Spasm of Accommodation refers to excessive exertion of accommodation and is often seen in children who attempt to compensate for a refractory anomaly that impairs their vision during excessive near work.
Orthoptic exercises on BYNOCS can help to break the spasm in such children. This condition may also result from other causes, such as the use of either systemic or topical cholinergic drugs, trauma, brain tumor, or myasthenia gravis.