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Near work symptoms and measures of accommodation in children

Angela M Chen1, Eric J Borsting1

  • 1Southern California College of Optometry, Marshall B Ketchum University, Fullerton, CA, USA.

Clinical & Experimental Optometry
|July 12, 2022
PubMed

Insights

Clinical accommodation tests, like amplitude and facility, are more strongly linked to near work symptoms in children than objective measures. These clinical assessments should be prioritized when evaluating visual discomfort in pediatric patients.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Visual Science

Background:

  • Children can experience significant near work symptoms, potentially due to accommodative deficits.
  • Research on near work symptoms and their association with accommodation in children is limited.

Purpose of the Study:

  • To investigate the relationship between clinical and objective measures of accommodation and symptoms experienced during near work in children.
  • To determine which type of accommodation measurement is more closely associated with reported near work symptoms.

Main Methods:

  • Compared 12 asymptomatic and 14 symptomatic children (ages 8-16) using the Convergence Insufficiency Symptom Survey (CISS).
  • Assessed accommodation via monocular amplitude, facility, and the monocular estimation method.
  • Utilized a WAM-5500 autorefractor for objective accommodative response at various distances (0.33-5 Diopters).

Main Results:

  • Symptomatic children had significantly higher CISS scores and reduced accommodative functions compared to asymptomatic children.
  • Clinical measures of accommodative amplitude and facility showed a stronger correlation with CISS scores than objective autorefractor measurements.
  • Objective measures of accommodation were significantly reduced in symptomatic children at 4D and 5D viewing distances.

Conclusions:

  • Clinical assessments of accommodative amplitude and facility are more strongly associated with near work symptoms in children than objective measurements.
  • Healthcare providers should consider measuring accommodative amplitude and facility in children presenting with visual discomfort during near tasks.
Abstract

Keywords:
Accommodationobjective measuressymptoms

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