Navigating Accommodative Dysfunction: A Focus on Your Focus

Accommodation is a crucial visual function that enables the eyes to adjust to focus on objects at different distances. When this process encounters challenges, it can result in accommodative dysfunction. Understanding the three primary types—accommodative insufficiency, accommodative infacility, and accommodative spasm—sheds light on distinct issues and helps identify potential symptoms.

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Photo by Andrea Piacquadio

Accommodation: A Brief Overview

Accommodation is the eye’s ability to adjust its focus for varying distances, primarily facilitated by changes in the tension of the ciliary muscle, which alters the shape of the eye’s natural lens. This mechanism ensures clear vision when transitioning between near and far objects. We will use the analogy of using your arm muscles to lift and hold a heavy grocery bag.

1. Accommodative Insufficiency

Accommodative insufficiency refers to the difficulty of the eye to increase its focusing power, particularly during close up tasks. In this condition, the eye struggles to provide sufficient accommodative power, leading to blurred vision and eye strain during activities that demand near vision, such as reading or using digital devices.

In the context of lifting a grocery bag, imagine the grocery bag is slightly too heavy for you. You might be able to lift it slightly, but you won’t be able to fully lift it, nor will you be able to hold it up. This can lead to fatigue as you try to make your muscles do more than they’re able to offer.

2. Accommodative Infacility

Accommodative infacility involves a reduced speed and adaptability in the eye’s focusing mechanism. The transition between near and far vision becomes sluggish, impacting the efficiency of the accommodative response. Individuals with accommodative infacility may experience difficulty smoothly adjusting their focus between near and far objects. This can impact tasks requiring rapid shifts in focus, like shifting between a whiteboard and a paper on your desk in the classroom.

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Photo by Max Fischer

In the context of lifting a grocery bag, imagine you’re trying to do bicep curls with your grocery bag. Although you may have sufficient power of your muscles, if your muscles have infacility, it’ll be difficult for you to do quick repetitions.

3. Accommodative Spasm

Accommodative spasm is characterized by a sudden, involuntary contraction of the eye’s focusing muscles. Typically your eyes spasm in the contracted state when you are looking at things up close and have difficulty relaxing. Accommodative spasm is often triggered by prolonged periods of close-up work. This often manifests as difficulty looking far away once you’re doing prolonged near tasks like being on your phone or reading a book.

Now imagine you’ve held your grocery bag with your arm bent for 10 minutes on your way home from the grocery store. You try putting your bag down but your arm has trouble straightening because it’s stiff and is temporarily stuck in the bent position. Over time, your arm will straighten, but as with most things, you “just have to give it time.”

Woman with glasses working on a laptop and reading a sheet of paper

Recognizing Symptoms

Common Symptoms of Accommodative Dysfunction:

  • Blurred Vision
  • Eye Strain
  • Headaches
  • Reduced Reading Efficiency
  • Eye Fatigue
  • Difficulty Transitioning Between Objects at Varying Distances

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Photo by Andrea Piacquadio

Possible Solutions for Accommodative Dysfunction

There can be many factors contributing to your symptoms. It is best to consult with your eye doctor to figure out the root cause and explore the best options for your eyes. Some solutions your doctor may recommend include:

  • Near Glasses: Near glasses can relieve the amount of strain put on your eyes and allow them to relax more.
  • Progressive Glasses: Progressive glasses have a gradient prescription that can be tailored for your accommodative demand at various distances.
  • Vision Therapy: Think of this like physical therapy for your eyes. There are training exercises you can do to help your accommodative focusing system.
  • Taking Breaks: Our world is very near-work heavy and sometimes a simple break to relax your eye muscles can help relieve your symptoms

Accommodative dysfunction can manifest in various ways, affecting daily tasks and overall visual comfort. Recognizing symptoms and understanding the specific type of dysfunction involved are crucial for seeking appropriate intervention. If you experience persistent visual discomfort or notice changes in your focusing ability, consulting with an eye care professional can provide valuable insights and help manage these conditions effectively.

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Photograph of Catherine Ong

Catherine Ong

Dr. Catherine Ong, OD, is an optometrist based in the Bay Area, California. She earned her doctorate from UC Berkeley, School of Optometry and currently provides primary and speciality eyecare in a private practice setting. She has a passion for patient education and enjoys reshaping technical concepts into digestable topics for all patients. When she is not seeing patients, you can find her exploring new restaurants, exercising, or trying out new recipes.