Accommodative Dysfunction Study Guide | Medicine Terms & Definitions

List the 5 different accommodative dysfunctions that we may encounter

- accommodative insufficiency

- ill-sustained accommodation

- accommodative excess / accommodative spasm

- accommodative infacility

- paresis and paralysis of accommodation

______________________ = not having the ability to accommodate properly

accommodative insufficiency

______________________ = decreased accommodation after long periods of time or periods of fatigue

ill-sustained accommodation

______________________ = too much accommodation for the stimulus

accommodative excess / accommodative spasms

______________________ = difficulty relaxing accommodation

accommodative excess / accommodative spasms

______________________ = difficulty with accommodative stamina over time

accommodative infacility

______________________ = difficulty looking far to near quickly

accommodative infacility

(+/-) lenses stimulate accomodation

(-)

(+/-) lenses relax accomodation

(+)

Going back and forth between (+) to (-) lenses is testing ___________

flexability of accommodation

Give the 3 very common complaint from px who may be suffering from any accommodative dysfunction

- asthenopia

- near blur

- HA after prolonged periods of reading

(generally accommodative dysfunctions have similar complaints but these complaints can lead you towards accommodative problems)

If your px has trouble stimulating accommodation, which 4 BV tests would you expect to have abnormal results in

- amps

- PRA

- facility (BAF and MAF) on the minus side

- high lag on FCC/MEM

* accommodative insufficiency or ill-sustained acomoadtion *

If your px has trouble relaxing accommodation, which 2 BV tests would you expect to have abnormal results in

- NRA

- facility (BAF and MAF) on the plus side

* accommodative excess or accommodative spams *

If your px has trouble with accommodation flexability, which BV test would you expect to have abnormal results in

- facility (BAF and MAF) on BOTH the plus and minus side

* accommodative infacility *

Give the formula used to calculate the expected average of Accommodative Amplitudes

average = 18 - (1/3 * age)

with a +/-2 SD

Give the formula used to calculate the expected minimum of Accommodative Amplitudes

average = 15 - (1/4 * age)

What are the goals for Accommodative Insufficiency treatment

- eliminate px sx

- improve amps, facility, stamina and create and accurate accom. response

What are the goals for Accommodative Excess treatment

- eliminate px sx

- help px more easily relax accommodation / eliminate spasm

- improve facility, stamina and create an accurate response

What are the goals for Accommodative Infacility treatment

- eliminate px sx

- improve facility and stamina

What are the goals for ill-Sustained Accommodation treatment

- eliminate px sx

- improve amps, facility, stamina and create and accurate accom. response

What are the goals for Paresis of Accommodation treatment

- find out the cause!

(systemic or meds?)

What are the recommendations for Accommodative Insufficiency treatment

- (+) lenses for near work

- VT

What are the recommendations for Paresis of Accommodation treatment

- (+) lenses in one eye or an unequal ADD

What are the recommendations for Accommodative Excess treatment

- VT

- low plus for reading or ADD

(start out with amounts as small as +0.25 or +0.50)

What are the recommendations for Accommodative Infacility treatment

- VT

What are the recommendations for ill-Sustained Accommodation treatment

- (+) lenses for near work (Add or NVO)

- VT

Px with accommodative insufficiency have trouble with (plus/minus) lenses

minus

Px with accommodative excess have trouble with (plus/minus) lenses

plus

Px with paresis of accommodative have trouble with (plus/minus) lenses

minus

Px with accommodative infacility have trouble with (plus/minus) lenses

BOTH!

(T/F) The AOA definition of Spasm of Accommodation includes the full near triad

TRUE

over-accommodation, over-convergence and miotic pupils

Variable and fluctuating VAs and refraction findings are commonly found in px with which accommodative dysfunction

accommodative excess