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Wednesday, January 16, 2008

AIPG 2005 - Ophthalmology - Accomodative Inertia

This question is from RxPG TargetPG 2005 Book
Question 274.
A 30-year-old man has 6/5 vision each eye, unaided. His cycloplegic retinoscopy is +1.0 D sph at 1 metre distance. His complaints are blurring of newsprint at 30 cm, that clears up in about two minutes. The most probable diagnosis is:
1. Hypermetropia.
2. Presbyopia.
3. Accommodative inertia.
4. Cycloplegia.
3. Accommodative inertia.
Optometric clinical practice guidelines (American Optometric Association).
Accommodative inertia, also called as accommodative infacility, can be defined as slow or difficult accommodative response to dioptric change—Unstimulus.
Cycloplegia hypermetropia or presbyopia do not “clear up in two minutes.”
Accommodative inertia typically occurs when the accommodative system is capable of but slow in making a change. In other words there is a considerable lag between the stimulus and response (starting trouble).
‘Plus’ lens can be prescribed initially, but vision therapy is highly effective in correcting accommodative inertia.

Interested reader can refer “Am J Optom Physiol Opt 1984;61:177-83
Relation of symptoms to accommodative infacility of school aged children—Hennessey D, Iosue RA, Rouse MV.