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Accommodation

Accommodation is the ability to change focus from a distant to a near target (and vice versa). It is a complex process in which the crystalline lens (i.e. the "camera lens" positioned on the inside of the eye) alters its shape to bring an object into focus. 

Function

Accommodation allows one to quickly bring a distant or near target into sharp focus. 

Accommodative Excess

Accommodative excess is a condition in which the eyes "over focus" on a near target. In other words, the eyes focus closer inward than where the object actually is. Some people like to think of it as a "focusing spasm." 

 

Accommodative excess may be functional in nature, in which the child fails to develop normal eye focusing abilities. It may also be due to acquired brain injury such as in a concussion. In both cases, vision therapy is the treatment of choice. In some cases, however, accommodative excess may be due to organic causes such as influenza, encephalitis, or trigeminal neuralgia and would require the consult of an ophthalmologist or neurologist. 

Signs and Symptoms

These symptoms are generally related to the use of the eyes for reading or other close work:

  • Blurred vision that is worse after reading or other close work

  • Headaches

  • Eyestrain

  • Difficulty focusing from far to near 

  • Sensitivity to light

Treatment

Vision therapy is the treatment of choice for accommodative excess. A therapy program should emphasize the ability to relax eye-focusing power and its integrating with vergence ("eye teaming") and oculomotor ("eye tracking") skills. 

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