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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.
Answer
3. Accommodative inertia.
Reference:
Optometric clinical practice guidelines (American Optometric Association).
Quality:
Thinker
QTDF:
??
Status:
New
Discussion:
Accommodative inertia, also called as accommodative infacility, can be defined as slow or difficult accommodative response to dioptric change—Unstimulus.
Explanation:
Cycloplegia hypermetropia or presbyopia do not “clear up in two minutes.”
Comments:
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).
Tips:
‘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.

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