Accommodation Disorders

Accommodative Disorders, or Accommodative Dysfunction, is a problem with focusing, particularly at near. This is not so much an eyesight (or clarity) difficulty as a problem in maintaining accurate, comfortable focus particularly with near work.

The Three Types of Accommodative Dysfunction

Accommodative Insufficiency

Difficulty efficiently sustaining focus at near. This is the most common type of accommodative dysfunction. The increased effort required to maintain clear vision at near can decrease performance on near tasks.

Accommodative Infacility

Difficulty efficiently switching focus between near and far and back.

Accommodative Spasm

A spasm of the focusing muscle which prevents the focusing muscles from fully relaxing. This generally causes blurry vision both near and far.

Physical Symptoms of Accommodative Dysfunctions

  • Blurred vision at near
  • Intermittent blurred vision at distance after reading
  • Difficulty switching between near and far
  • Eye strain
  • Headaches- especially over the brow or temples
  • Eye fatigue
  • General fatigue, especially later in the day
  • Symptoms often are worse when tired, later in the day or during tasks

People with Accommodative Dysfunction may also avoid near point work like reading or writing, they may hold material they are reading very close or very far away from their eyes, or they may have poor reading fluency or comprehension. They often have difficulty copying from the board, difficulty sustaining attention (especially on near work), have poor attention to details, and may require frequent breaks in order to complete work.

Accommodative Dysfunction and Children

Accommodative Dysfunction is a relatively common visual deficiency that can have a significant impact on a child’s quality of life. Accommodative Dysfunction has been studied and linked to an array of symptoms associated with near visual work such as reading or computer based tasks. It has also been linked to reading problems in children.


Treatment may include the prescribing of lenses to help reduce eye strain at near and/or optometric vision therapy.

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