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Purpose
To determine the prevalence of accommodative insufficiency (AI) and its relation with age, gender, and refractive errors in a college-age student population in Iran.
Methods
The present study was conducted cross-sectionally in 2017. All students had optometric tests including measurement of visual acuity, objective and subjective refractio...
Contexts in source publication
Context 1
... mean of spherical equivalent in myopic and hyperopic individuals were −1.83 ± 1.67 (−0.63 to −14.55) and 1.01 ± 0.65 (0.63 to 2.63), respectively. The prevalence of AI has been shown in Table 1. The overall prevalence of AI in this study was 4.07% (95% CI: 2.61---5.52); ...Context 2
... = 0.009). As demonstrated in Table 1, the prevalence of AI showed no linear trend with age. Overall, chi-square test showed no significant relationship between age and the prevalence of AI (p-value = 0.848). ...Context 3
... chi-square test showed no significant relationship between age and the prevalence of AI (p-value = 0.848). Table 1 also shows the prevalence of AI in different groups of refractive status; there was no significant difference in AI prevalence among these three groups (p-value = 0.869). Fig. 1 shows the distribution of AA, MAF and AR in participants with and without AI. ...Context 4
... the present study, we also examined the association between age and AI prevalence. As seen in Table 1, the lowest prevalence of AI (2.59%) was observed in the 18---19-year age range, and the highest prevalence (4.45%) was in 20---21-year-olds. Except for 18---19-year-olds who had a relatively low AI prevalence, the rates were approximately similar in other age groups. ...Citations
... Jorge et al [21] studied football players' race, position, age, and refractive status and found no significant difference in the distribution of binocular vision impairment between the above factors. Hashemi et al [22] discovered a substantial correlation between AI and gender among Iranian college students, with women being more commonly affected. This study has some limitations. ...
AIM: To investigate the frequency and associated factors of accommodation and non-strabismic binocular vision dysfunction among medical university students. METHODS: Totally 158 student volunteers underwent routine vision examination in the optometry clinic of Guangxi Medical University. Their data were used to identify the different types of accommodation and non-strabismic binocular vision dysfunction and to determine their frequency. Correlation analysis and logistic regression were used to examine the factors associated with these abnormalities. RESULTS: The results showed that 36.71% of the subjects had accommodation and non-strabismic binocular vision issues, with 8.86% being attributed to accommodation dysfunction and 27.85% to binocular abnormalities. Convergence insufficiency (CI) was the most common abnormality, accounting for 13.29%. Those with these abnormalities experienced higher levels of eyestrain (χ2=69.518, P<0.001). The linear correlations were observed between the difference of binocular spherical equivalent (SE) and the index of horizontal esotropia at a distance (r=0.231, P=0.004) and the asthenopia survey scale (ASS) score (r=0.346, P<0.001). Furthermore, the right eye's SE was inversely correlated with the convergence of positive and negative fusion images at close range (r= -0.321, P<0.001), the convergence of negative fusion images at close range (r=-0.294, P<0.001), the vergence facility (VF; r=-0.234, P=0.003), and the set of negative fusion images at far range (r=-0.237, P=0.003). Logistic regression analysis indicated that gender, age, and the difference in right and binocular SE did not influence the emergence of these abnormalities. CONCLUSION: Binocular vision abnormalities are more prevalent than accommodation dysfunction, with CI being the most frequent type. Greater binocular refractive disparity leads to more severe eyestrain symptoms.
... Children are the subjects more affected by this disorder, reaching a prevalence of 61.6% between 6 and 16 years old [25]. High school students and university students are also affected by AI, with prevalence between 4.1% and 6.2% [27][28][29]. ...
Given the relationship between spherical aberrations and accommodation, the study of these aberrations can be helpful to understand accommodative response in subjects with accommodative dysfunctions. The purpose of this study was to evaluate on-axis and off-axis changes of primary and secondary spherical aberrations, Z(4,0) and Z(6,0), with accommodation in subjects with accommodative insufficiency (AI). Ten subjects with AI and eleven without any accommodative dysfunction (control) participated in this study. On-axis defocus Z(2,0), Z(4,0), and Z(6,0) were obtained in both groups with a Hartmann–Shack aberrometer for the unaccommodated state and with 1.00 D, 2.44 D, 3.83 D, and 4.73 D of accommodative stimuli. Z(4,0) and Z(6,0) were also measured on 11.5° and 23° temporal, nasal, superior, and inferior retinal areas for unaccommodated state and for 2.44 D of accommodative stimulus. In the control group, Z(4,0) became more negative with accommodation and Z(6,0) became more positive, as was expected according to previous studies. This tendency was not observed in the group of subjects with AI group for Z(4,0) or for Z(6,0). No differences on off-axis Z(4,0) and Z(6,0) were observed between the groups. The changes of spherical aberrations with accommodation seem different in subjects with AI compared to those without any accommodative dysfunction. Those with AI do not present a decrease in Z(4,0) and an increase in Z(6,0) with accommodation as occurs in eyes without this type of dysfunction. Understanding how the optics of the eye changes with accommodation can be helpful to understand the origin of accommodative dysfunctions.
... [25] Several studies reviewing the prevalence of symptomatic accommodative dysfunction amongst non-presbyopic patients suggest AI is the most common finding. [26] Most data account for the prevalence of accommodative dysfunction amongst school children ranging from 8 to 15 years of age. [27] Studies have shown that most children with CI also tend to have accommodative dysfunction. ...
Accommodative insufficiency is a condition characterized by a reduced ability to carry out near work. It occurs in as much as 10% of the population. It is the most common form of accommodative dysfunction in non-presbyopic disorders. This article describes the optics of the human eye and the principles of ametropia. The article also explains the concepts involved in a thorough differential diagnosis and managing patients with this condition. An interprofessional healthcare team approach is emphasized in helping patients with accommodative insufficiency. Objectives: Describe accommodative insufficiency and explain methods of diagnosis. Review the risk factors for developing accommodative dysfunction. Explain the common physical exam findings associated with accommodative insufficiency. Outline the typical presentation and differential diagnosis of a patient with accommodative insufficiency.
... Strabismic binocular vision anomalies are associated with congenital or acquired strabismus, whereas NSBVAs consist of accommodative and vergence dysfunctions [6,7]. NSBVAs is more prevalent among the population who spend more time performing near work [8]. Focusing the eyes at a fixed distance for prolonged periods demands high visual efficiency that may result in various accommodative and vergence dysfunctions [9]. ...
Background: Focusing the gaze for prolonged periods on a fixed distance demands high visual efficiency in handloom silk weavers and might result in various accommodative and vergence dysfunctions. The aim of the present study was to assess accommodative and vergence parameters and determine the frequency of non-strabismic binocular vision anomalies (NSBVAs) among handloom silk weavers. Methods: In this cross-sectional study, we recruited voluntary handloom silk weavers from the Government-aided Society of Arignar Anna Silk Co-op Society K.H.-1, Kanchipuram, aged 20–39 years. All participants underwent preliminary visual examinations and comprehensive binocular vision testing of accommodative and vergence parameters. Sensory evaluation was performed using stereopsis testing and the Worth 4 Dot test. Motor evaluation included the ocular motility assessment, heterophoria checks for distance and near, near point of convergence, negative and positive fusional vergences for distance and near, vergence facility, negative and positive relative accommodations, both monocular and binocular near points of accommodation, and accommodative facility. The monocular estimate method was used to determine the accommodative response. Quantitative data are expressed as mean (standard deviation [SD]), and qualitative data are expressed as frequency (percentage). Results: We recruited a total of 72 weavers, including 41 (56.9%) men and, 31 (43.1%) women with mean (SD) age, working hours, and work experience of 34.15 (4.12) years, 9 (2.5) h/day, and 17.5 (6.9) years, respectively. Of the 29 (40.3%) weavers with a refractive error, 18 (25%) had astigmatism; seven (9.7%) had myopia; and four (5.6%) had hyperopia. Of the 72 weavers, 38 (52.8%) presented with NSBVAs, including 13 (18.1%) with accommodative dysfunctions, 11 (15.3%) with vergence dysfunctions, and 14 (19.4%) with combined accommodative and vergence dysfunctions. Accommodative insufficiency was the most prevalent dysfunction among all NSBVAs. Overall, 57 (79.2%) patients reported vision-related symptoms during their weaving hours, all with NSBVAs (n = 38), 19 with normal parameters in the binocular vision test, and 15 with no symptoms. Conclusions: The frequency of NSBVAs was high among handloom silk weavers compared to the literature. This implies a need for comprehensive binocular vision examination for people in this occupation to rule out NSBVAs for improving their quality of life and occupational productivity. Future large-scale studies are required to determine the exact NSBVAs prevalence among workers of this near vision-related occupation.
... It was repeated thrice and the average measurement was noted. The accommodative amplitude in centimeters was then converted to amplitude of accommodation in diopters by dividing it by 100 [32]. The procedure was done both monocularly and binocularly. ...
Purpose
To determine the binocular vision status in normally-sighted school aged children who used digital devices.
Methods
A cross-sectional study was conducted at B.P. Koirala Lions Center for Ophthalmic Studies, Kathmandu, Nepal for a duration of one year. One hundred and eighty school aged children (71 female and 109 male) aged 7 to 17 years were included in the study. All the children underwent detailed ophthalmic and binocular vision examinations. The duration of the use of digital devices by the children were asked to either the parents or guardians present at the time of the study. The study participants were divided into two groups: children who used digital devices for the last six months (users group) and those who hadn’t used digital devices for the last six months (non users group). The users group was again divided into two subgroups: children who used digital devices for less than 3 hours per day and a day per week (low digital device users subgroup) and children who used digital devices for more than 3 hours per day and all days in a week (high digital device users subgroup).
Results
Accommodative amplitudes, accommodative facility, and positive fusional vergence for both near and distance were significantly reduced in the high digital device users group than in the low digital device users subgroup (p <0.01). Stereo acuity, near point of convergence, and negative fusional vergences for both near and distance were not statistically significantly different between the two subgroups. Prevalence of accommodative and vergence anomalies (except convergence insufficiency) was more in the high digital device users subgroup than in the low digital device users subgroup (p<0.01).
Conclusions
Children who used digital devices for a significantly greater amount of time had significantly reduced amplitudes of accommodation, accommodative facility, and positive fusional vergence both at near and distance.
... Some factors including distance visual acuity, accommodation capability, and near vision correction affect the near visual acuity [29]. The frequency of accommodative insufficiency ranges between 0.2 and 39 percent in paediatrics which decreases the near-distance performance [30,31] On the other hand, some paediatric ocular disease such as congenital cataract, retinopathy of prematurity corneal disorders and, etc. contributes to simultaneous distance and near vision impairment. Low vision in children especially at near distance can be improved by low vision aids [26]. ...
Objective: To assess the trend of paediatric visual impairment and its disparities by year, sex, age and national socioeconomic levels using disability-adjusted life years (DALYs).
Methods: It is a retrospective analysis of data from the Global Burden of Disease (GBD) 2017. Global and national DALY numbers and rates of vision impairment in three paediatric age groups of 1–4 (preschool children), 5–9 (school children) and 10–14 years (teenagers) years were obtained from the GBD 2017 database. The socioeconomic indices for 195 countries were derived from international open databases. Main outcome measures were comparison of DALYs due to paediatric vision impairment in different age groups by socioeconomic indicators in 2017 and analysis of the trend from 1990.
Results: The global prevalence of distance and/or near vision impairment for 1–14 years was 2.8% (95% uncertainty interval (UI): 2.5–3.1) in 2017. The highest DALYs for distance and/or near vision impairment [number=589.93 thousands (95%UI: 367.71–933.29), rate = 92.72 (95%UI: 57.79–146.68)] were observed in teenagers. DALY rate of distance and/or near vision impairment was not associated with socioeconomic indicators, however, DALY rate of refractive disorders had positive correlation with national socioeconomic development. The global trends of DALY numbers in distance and/or near vision impairment as well as refractive and other causes remained stable from 1990 to 2015 (0.128 ≤ P ≤ 0.738), however, DALY rates had a statistically significant trend of reduction in all paediatric age groups (0.003 ≤ P ≤ 0.024).
Conclusion: The global health burden of paediatric vision impairment decreased from 1990. Refractive, near vision impairment and other causes were associated with socioeconomic development.
... 21 years old, i.e., the critical period (8). Students form a remarkable proportion of the young population (about 4 million) (9). There are inconsistent statistical reports on the prevalence of addiction among students; however, its prevalence rate is estimated to be 2% -10% on average, including 2.6% of students from Science Ministry Universities and 1.6% of students from Medical universities (10). ...
Background: Addiction is one of the most prominent problems and the fourth leading crisis worldwide. In Iran, this issue is more complicated because of increasing young population in this country. Objectives: This study aimed to predict addiction susceptibility regarding students’ personality traits at Qazvin universities. Methods: In this cross-sectional study, 227 students from Qazvin universities were selected using the multistage random stratified sampling method. Data collection tools were demographic information form, Addiction Susceptibility questionnaire (ASQ), and NEO personality inventory. After collecting the required data, SPSS software version 21 was used to analyze the data by running variance analysis and paired sample t-test. Results: In this study, neuroticism (P = 0.031) and openness (P = 0.043) with regression coefficients of 0.584 and 0.586 had positive and significant effects on addiction susceptibility, respectively. In contrast, extraversion (P = 0.023), agreeableness (P = 0.038), and consciousness (P < 0.001) with regression coefficients of -0.639, -0.186, and -1.342 had negative and significant effects on addiction susceptibility, respectively. Conclusions: The findings revealed a significant relationship between personality traits and addiction susceptibility. Accordingly, the aforementioned psychological traits must be empathized in educational, preventive, and therapeutic programs so that the vulnerable groups, including students, would receive some help.
... Among college students, the prevalence of AI was reported to be 4.07% and 4.5% in Iran and South Africa, respectively. 18,19 A school children-based study in southern India reported a low prevalence of 0.2% 8 ...
... 22 Similarly, children with Down syndrome are found to have poorer accommodative amplitudes for their age, resulting in a high prevalence of AI ranging between 55% and 76%. 18,[23][24][25][26][27] Although all these studies were primarily cross-sectional in nature and conducted on student populations at school or university level, there is a vast heterogeneity across studies. The huge variation in the sample size and methodological differences are potential confounders limiting the comparison of prevalence statistics. ...
... DS lens at 40 cm is recommended as a standard testing method. Most studies have shown reduced accommodative facility with difficulty in clearing minus lenses in AI. 2,8,[18][19][20] The amplitude scaled facility 61 is considered to have better sensitivity over the standard ±2.00 DS in differentiating symptomatic and asymptomatic adult subjects. ...
Purpose
Accommodative insufficiency (AI), defined as the inability to stimulate accommodation in pre-presbyopic individuals, has gained much attention over recent years. Despite the enormity of the available information, there is a significant lack of clarity regarding the criteria for definition, methodology adopted for testing and diagnosis, and the varied prevalence across the globe. This review aims to gather evidence that is pertinent to the prevalence, impact and efficacy of available treatment options for AI.
Methods
PubMed, Google Scholar and Cochrane Collaboration search engines were used with the keywords prevalence, accommodative insufficiency, symptoms, plus lens, vision therapy and treatment. Peer-reviewed articles published between 1992 and 2019 were included in the review. After reviewing the studies for study methodology and robustness, 83 articles were chosen for this literature review.
Results
The prevalence of AI ranges between <1.00% and 61.6% across studies. The prevalence shows considerable variation across ethnicities and age groups. There is significant variation in the study methodology, diagnostic criteria and number of tests performed to arrive at the diagnosis. Not many studies have explored the prevalence beyond 20 years of age. The prevalence of AI is high among children with special needs. There is no high-quality evidence regarding the standard treatment protocol for AI. Both vision therapy and low plus lenses have shown efficacy in independent studies, and no studies have compared these two treatment options.
Conclusion
The understanding of AI prevalence is currently limited owing to the lack of a standard set of diagnostic criteria and wide variations in the study methodology. There is a lack of high-quality evidence suggesting the best possible treatment for AI. The current gaps in the literature have been identified and future scope for exploration is elucidated.
... 5 ---7 Therefore, AI can interfere with academic and educational learning, which is especially important in children and school-age students. 8 There is a great variability regarding the prevalence of AI in children. As reported in various studies, prevalence rates can range from 2.0% 9 to 61.7%, 10 depending on the studied population and diagnostic criteria. ...
Purpose
To assess differences in a new objective metric obtained with a double-pass technique between a group with accommodation insufficiency (AI) and a control group and to explore the diagnostic capabilities of this new tool in comparison to conventional procedures.
Methods
Retrospective cross-sectional case-control phase 1 study. Two groups with ages ranging from 8 to 18 years were recruited: AI and control group. The diagnostic criterion of AI was based on monocular accommodative amplitude (AA), 2 D below Hofstetter’s calculation for minimum AA, and monocular accommodative facility (MAF), failing with minus lens and cut-off at ≤ 6 cycles per minute. Accommodative response with a double pass device (HD Analyzer, Visiometrics) was measured, performing an evaluation from +1.00 D to −3.50D (−0.5D steps), offering the width of the profile at 50% (WP) in minutes of arc.
Results
Differences were found between groups for the AA, MAF and MEM retinoscopy (p < 0.0001, p < 0.001, p = 0.037). The discriminative capacity of MEM retinoscopy for AI diagnosis was significant and the cut-off that maximized the sensitivity and specificity was > 0.5 D. Considering WP 50% in different points, the discriminative AI diagnosis capacities for the points of 2.0 D and 2.50 D were significant (ROC-AUC 0.78; p = 0.03 and p = 0.02).
Conclusions
Double-pass system metric differed between patients with AI and control group, therefore the aim of a Phase I study was achieved. Further steps with higher sample sizes are required to evidence if the system really provides any advantage versus conventional methods in the diagnosis of AI.
... Según Borsting, estudios realizados en Irán en una población joven demostró, que los trastornos acomodativos sintomáticos se relacionan con mayor frecuencia a conductas con bajo rendimiento y atención escolar, estos trastornos también representan un impacto en el rendimiento deportivo y desempeño laboral, especialmente en ocupaciones que implican cantidades considerables de trabajo cercano; como usuarios de computadoras (oficinistas) o lectores continuos (Hashemi, 2018). ...
The article shows the results of an observational, descriptive and correlational study carried out in the "Arturo Borja Educational Unit" of the province of Orellana, from February to December 2018, with the objective of determining accommodative dysfunctions in non-strabismic students of 13 to 18 years, from the collection of information in their optometric medical records. The main results corroborate the accommodative excess as the most significant dysfunction; where there is a relationship between accommodative dysfunctions and ametropia, except for the inflexibility that occurs in emmetropia.
