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Accommodation Wps Office

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33 views20 pages

Accommodation Wps Office

Uploaded by

tkbj2vmrjg
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Anomalies of accommodation

Diminished accommodation
1. Physiological (presbyopia)
2. Pharmacological (cycloplegia)
3. Pathological
• Insufficiency of accommodation
• Sustained accommodation
• Paralysis of accommodation
Increased accommodation

1. Excessive accommodation
2. Spasm of accommodation

PRESBYOPIA
• Presbyopia is not an error of refraction but a
condition of Physiological insufficiency of
accommodation due to reduced amplitude of
accommodation leading to a progressive fall
of near vision.
• These begins between 40 years and 45 years.
• After the age of 40 the NPA reduces beyond the
normal reading distance.
• This condition of falling near vision due to age
related decrease in the amplitude of
accommodation of increases in pactum proximum
is presbyopia.

Causes of presbypoia

• Age related change in lens which include:-


# Decreases in elasticity of lens capsule
# Progressive increase in size and hardness
( sclerosis) of the lens substance.

Causes of premature presbyopia include:-

• Uncorrected hypermetropia.
• Premature sclerosis of crystalline lens.
• General ability causing present weakness of
ciliary muscles.
• Chronic simple glaucoma.
Symptoms

• Difficulty in near vision.


• Authentic symptoms.
• Intermittent diplopia at near may develop.

Treatment

• Spectacles( Convex lens).


• Contact lenses.
• Surgical treatment of presbyopia.
• Spectacle
Contact lens
1. Mono vision
2. Bifocal/multifocal

MONOFOCAL CL
• One eye is corrected for distant vision other eye for near
vision
BIFOCAL CL
• Popular in RGP
• Near and far can’t be seen clearly same time
• Surgery
• LASIK
• Multifocal intraocular lens(can be used to treat presbyopia
after cataract surgery.multifocal iol s are designed to help pts
see at different distance and can reduce the need for the
glasses)

• Conductive keratoplasty(CK)
• https://www.google.com/gasearch?q=conductive%20kerato
plasty&source=sh/x/gs/m2/5
• A thin probe is inserted in to the cornea and emits radio
waves that create heat in the surrounding tissue .this causes
the collagen inthe area to shrink, which flattens the
peripheral cornea and steepens the central cornea
• Usually it is painless, though some pts may feel pressure
• The doctor uses anaesthetic eye drops to numb the area
before the procedure
INSUFFICIENCY OF ACCOMMODATION
• Accommodative power is significantly and
persistently below the normal Physiological limits
for the patients age.

Causes

• Premature sclerosis of lens.


• Weakness of ciliary muscles due to systemic
causes such as diabetes melitus
Clinical features
• Headache
• fatigue
• Blurring of near vision
• Intermittent diplopia
Treatment

• Near vision spectacles


• Accommodation exercise
• Accommodation exercise
• HART CHART
• Hart chart helps to train our accommodative system,which is
the ability to change focus from distance to near

https://youtu.be/fX8
mqtgdzgs?si=C8dH9
dJmP1DVbNH3
• Procedure
• Tape the chart with the large block of letters on the
wall at eye level
• Stand about 6 feet away from the large chart while
holding the small chart in your hand about reading
distance away from your eyes
• Read the first letter in the first row on the large
chart,then jumb your eyes to the small chart to read
the first letter in the first row
• Alternate moving your eyes back and forth quickly
reading the entire row
PARALYSIS OF ACCOMMODATION
• Paralysis of accommodation, also know as
cycloplegia refers to complet absence of
accommodation.

Causes

• Drug induced
• Internal ophthalmoplegia
• paralysis of accommodation as a component
of 3 rd nerve palsy
Clinical features
• Blurring of near vision
• Photophobia
• Micropsia
• Abnormal reducing of near point
• Sign of 3rd nerve palsy

Treatment

• Self recovery- drug induced paralysis and in


cases when systemic cause treated.
• Dark glasses- reduce glare
• Convex lens- for near vision if paralysis is
permanent.

EXCESSIVE ACCOMMODATION

• A situation in which an individual exerts mare


than the normal required accommodation for
performing a certain near work.
• Excessive near work is an important
precipitating factor especially when done in
inadequate illumination.
Clinical features

• Varying degree of blurred vision.


• Symptoms of accommodation asthenopisa.
• Near vision difficulties.

Treatment

• Optical treatment- correct RE


• General treatment- near work should be
minimised and when done should be in proper
illumination.
• The General health of then patient should be
improved.
• https://youtube.com/watch?v=Y3WT-
fCEseM&feature=shared
_THANK YOU_

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