Accommodative and convergence anomalies in patients with opioid use disorder

Considering the significant relationship between opioid abuse and some accommodative and convergence disorders, opioid use should be considered in the differential diagnosis and will directly affect the management plan.

To determine the prevalence of accommodative and convergence anomalies and their related factors in a population of male young adults with opioid use disorder (OUD).

This cross-sectional study was conducted using a convenience sampling method in 2019. The study sample included male young adults with OUD who had been referred to a specialised drug-dependence rehabilitation centre in Mashhad, Iran. The diagnosis of OUD was made by a psychologist based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. All patients underwent complete optometric examinations.

Eighty male young adults with OUD were included in this study. The mean age of participants was 30.5 ± 3.9 years (age range 19 to 35 years). The prevalence of accommodative and convergence disorders was 33.75% (95% CI: 23.55-45.19) and 25.00 (95% CI: 15.99-35.94), respectively. Accommodative insufficiency (22.5%, 95% CI: 13.91-33.21) had a higher prevalence than accommodative excess (3.75%, 95% CI: 0.78-10.57) and accommodative infacility (7.50%, 95% CI: 2.80-15.61). Convergence insufficiency (18.75%, 95% CI: 10.89-29.03) had a higher prevalence compared to convergence excess (3.75%, 95% CI: 0.78-10.57) and basic exophoria (2.50%, 95% CI: 0.30-8.74). According to the multiple logistic regression, a significant inverse relationship was observed between pupil size with accommodative insufficiency (OR = 0.45), accommodative infacility (OR = 0.67), and convergence insufficiency (OR = 0.55).

The results of the present study showed a higher prevalence of some accommodative and convergence disorders in OUD patients compared to the prevalence reported in previous studies conducted on the normal populations with a similar age range.