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==Overview==
==Overview==
'''Accommodative insufficiency''' (AI) involves the inability of the [[eye]] to focus properly on an object. Approximately 80 percent of children diagnosed with CI ([[convergence insufficiency]]) also demonstrate AI.
'''Accommodative insufficiency''' (AI) involves the inability of the [[eye]] to focus properly on an object. Approximately 80 percent of children diagnosed with CI ([[convergence insufficiency]]) also demonstrate AI.
==Causes==
===Common Causes===
*[[Antidepressants]]
*Extreme [[fatigue]]
*[[Diabetes mellitus]]
*[[Head trauma]]
===Causes by Organ System===
{|style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Anemia]], [[arteriosclerosis]], [[diabetes mellitus]], [[Down syndrome]], [[myotonic dystrophy]], [[thyroid disease]] 
|-
|-bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Decompression sickness]], [[measles]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Antidepressants]], [[antihistamines]], [[ritalin]], sulphasalazine
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Down syndrome]], [[Fragile X syndrome]], [[measles]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetes mellitus]], [[myotonic dystrophy]], [[thyroid  disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Chronic  alcoholism]], [[decompression sickness]], [[diabetes mellitus]], [[Down syndrome]], [[measles]], [[multiple sclerosis]], [[myasthenia gravis]], [[myotonic dystrophy]], [[thyroid disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Down syndrome]], [[Fragile  X syndrome]], [[myotonic dystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Anemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|[[Influenza]], [[whooping cough]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"|[[Decompression  sickness]], [[diabetes mellitus]], [[Down syndrome]], [[Fragile X syndrome]], [[multiple sclerosis]], [[myasthenia gravis]], [[myotonic dystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Cerebral  palsy]], [[chronic alcoholism]], [[decompression  sickness]], [[diabetes mellitus]], [[Down syndrome]], [[extreme fatigue]], [[Fragile X syndrome]], [[head trauma]], left [[middle cerebral artery]]  occlusion, [[measles]], [[mild traumatic brain  injury]], [[multiple sclerosis]], [[myasthenia gravis]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Chronic  alcoholism]], [[diabetes mellitus]], [[malnutrition]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Fragile X syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"|[[Amblyopia]], [[arteriosclerosis]], [[astigmatism]], [[cerebral palsy]], [[convergence  insufficiency]], [[cycloplegia]], [[decompression  sickness]], [[diabetes mellitus]], [[Down syndrome]], [[eye strain]], [[Fragile X syndrome]], [[hyperopia]], inability of the ciliary  body to contract, [[influenza]], [[measles]], [[mild traumatic brain  injury]], [[multiple sclerosis]], [[myasthenia gravis]], [[myopia]], [[myotonic dystrophy]], ocular [[inflammation]], [[presbyopia]], [[pseudomyopia]], sclerosis of the crystalline  lens, senile [[cataract]], [[spasm of  accommodation]], [[thyroid disease]], [[uveitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Down syndrome]], [[multiple sclerosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Decompression sickness]], [[influenza]], [[measles]], [[myasthenia gravis]], [[whooping cough]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Diabetes mellitus]], [[Down syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Myasthenia gravis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| [[Fragile X syndrome]], [[multiple sclerosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Head  trauma]], [[mild traumatic brain  injury]], [[whiplash]] injuries
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"|[[Multiple sclerosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Aging]], altitude, [[extreme fatigue]], [[eye strain]], high [[stress]], [[idiopathic]], [[multiple sclerosis]], video display terminals  (VDT) users
|-
|}
===Causes in Alphabetical Order===
<ref>Duke-Elder S. System of Ophthalmology, vol V Ophthalmic Optics and Refraction. St Louis, Mosby, 1970 451- 486.</ref><ref>Cooper J. Accommodative dysfunction. In: Amos JF. Diagnosis and management in Vision Care. Boston: Butterworths, 1987 431-54.</ref><ref>Daune A. Anomalies of Accommodation clinically considered. Trans Am Ophthalmol Soc. 1913 1 386- 400.</ref><ref>Scheiman M, Wick B. Clinical management of binocular vision: Heterophoric, Accommodative, and Eye movement disorders. 2nd ed. Philadelphia: Lippincott Williams and Wilkins, 2002: 334-369.</ref><ref>Daum KM. Accommodative insuffi ciency. Am J Optom Physiol Opt 1983a 60 352-359.</ref>
*[[Aging]]
*Altitude
*[[Amblyopia]]
*[[Anemia]]
*[[Antidepressants]]
*[[Antihistamines]]
*[[Arteriosclerosis]]
*[[Astigmatism]]
*[[Cerebral palsy]]<ref name="pmid18046282">{{cite journal| author=Roche O, Roumes C, Parsa C| title=[Techniques for measuring phakic and pseudophakic accommodation. Methodology for distinguishing between neurological and mechanical accommodative insufficiency]. | journal=J Fr Ophtalmol | year= 2007 | volume= 30 | issue= 9 | pages= 953-60 | pmid=18046282 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18046282  }} </ref>
*[[Chronic alcoholism]]
*[[Convergence insufficiency]]
*[[Cycloplegia]]
*[[Decompression sickness]]<ref name="pmid7213164">{{cite journal| author=Lieppman ME| title=Accommodative and convergence insufficiency after decompression sickness. | journal=Arch Ophthalmol | year= 1981 | volume= 99 | issue= 3 | pages= 453-6 | pmid=7213164 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7213164  }} </ref>
*[[Diabetes mellitus]]
*[[Down syndrome]]<ref name="pmid18046282">{{cite journal| author=Roche O, Roumes C, Parsa C| title=[Techniques for measuring phakic and pseudophakic accommodation. Methodology for distinguishing between neurological and mechanical accommodative insufficiency]. | journal=J Fr Ophtalmol | year= 2007 | volume= 30 | issue= 9 | pages= 953-60 | pmid=18046282 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18046282  }} </ref>
*[[Extreme fatigue]]
*[[Eye strain]]
*[[Fragile X syndrome]]<ref name="pmid7629369">{{cite journal| author=Amin VR, Maino DM| title=The fragile X female: a case report of the visual, visual perceptual, and ocular health findings. | journal=J Am Optom Assoc | year= 1995 | volume= 66 | issue= 5 | pages= 290-5 | pmid=7629369 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7629369  }} </ref>
*[[Head trauma]]
*High [[stress]]
*[[Hyperopia]]
*[[Idiopathic]]
*Inability of the ciliary  body to contract
*[[Influenza]]
*Left [[middle cerebral artery]] occlusion<ref name="pmid3394770">{{cite journal| author=Ohtsuka K, Maekawa H, Takeda M, Uede N, Chiba S| title=Accommodation and convergence insufficiency with left middle cerebral artery occlusion. | journal=Am J Ophthalmol | year= 1988 | volume= 106 | issue= 1 | pages= 60-4 | pmid=3394770 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3394770  }} </ref>
*[[Malnutrition]]
*[[Measles]]
*[[Mild traumatic brain  injury]]<ref>http://www.rehab.research.va.gov/jour/10/473/Green.html</ref>
*[[Multiple sclerosis]]
*[[Myasthenia gravis]]<ref name="pmid8583227">{{cite journal| author=Matsui M, Enoki M, Matsui Y, Oono S, Ohta M, Suenaga A et al.| title=Seronegative myasthenia gravis associated with atonic urinary bladder and accommodative insufficiency. | journal=J Neurol Sci | year= 1995 | volume= 133 | issue= 1-2 | pages= 197-9 | pmid=8583227 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8583227  }} </ref>
*[[Myopia]]
*[[Myotonic dystrophy]]
*Ocular [[inflammation]]
*[[Presbyopia]]<ref name="pmid18046282">{{cite journal| author=Roche O, Roumes C, Parsa C| title=[Techniques for measuring phakic and pseudophakic accommodation. Methodology for distinguishing between neurological and mechanical accommodative insufficiency]. | journal=J Fr Ophtalmol | year= 2007 | volume= 30 | issue= 9 | pages= 953-60 | pmid=18046282 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18046282  }} </ref>
*[[Pseudomyopia]]
*[[Ritalin]]
*Sclerosis of the  crystalline lens
*Senile [[cataract]]
*[[Spasm of accommodation]]<ref name="pmid6884172">{{cite journal| author=Daum KM| title=Accommodative dysfunction. | journal=Doc Ophthalmol | year= 1983 | volume= 55 | issue= 3 | pages= 177-98 | pmid=6884172 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6884172  }} </ref>
*Sulphasalazine<ref name="pmid8102809">{{cite journal| author=Magnus JH, Elverland HH, Olsen EG, Husby G| title=Facial palsy and partial accommodative insufficiency associated with sulphasalazine treatment in a patient with ankylosing spondylitis. | journal=Scand J Rheumatol | year= 1993 | volume= 22 | issue= 4 | pages= 199-201 | pmid=8102809 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8102809  }} </ref>
*[[Thyroid disease]]
*[[Uveitis]]
*Video display terminals  (VDT) users<ref name="pmid8888886">{{cite journal| author=Scheiman M| title=Accommodative and binocular vision disorders associated with video display terminals: diagnosis and management issues. | journal=J Am Optom Assoc | year= 1996 | volume= 67 | issue= 9 | pages= 531-9 | pmid=8888886 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8888886  }} </ref>
*[[Whiplash]] injuries
*[[Whooping cough]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
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[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]


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Latest revision as of 15:20, 17 July 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Accommodative insufficiency (AI) involves the inability of the eye to focus properly on an object. Approximately 80 percent of children diagnosed with CI (convergence insufficiency) also demonstrate AI.

Causes

Common Causes

Causes by Organ System

Cardiovascular Anemia, arteriosclerosis, diabetes mellitus, Down syndrome, myotonic dystrophy, thyroid disease
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Decompression sickness, measles
Drug Side Effect Antidepressants, antihistamines, ritalin, sulphasalazine
Ear Nose Throat Down syndrome, Fragile X syndrome, measles
Endocrine Diabetes mellitus, myotonic dystrophy, thyroid disease
Environmental No underlying causes
Gastroenterologic Chronic alcoholism, decompression sickness, diabetes mellitus, Down syndrome, measles, multiple sclerosis, myasthenia gravis, myotonic dystrophy, thyroid disease
Genetic Down syndrome, Fragile X syndrome, myotonic dystrophy
Hematologic Anemia
Iatrogenic No underlying causes
Infectious Disease Influenza, whooping cough
Musculoskeletal/Orthopedic Decompression sickness, diabetes mellitus, Down syndrome, Fragile X syndrome, multiple sclerosis, myasthenia gravis, myotonic dystrophy
Neurologic Cerebral palsy, chronic alcoholism, decompression sickness, diabetes mellitus, Down syndrome, extreme fatigue, Fragile X syndrome, head trauma, left middle cerebral artery occlusion, measles, mild traumatic brain injury, multiple sclerosis, myasthenia gravis
Nutritional/Metabolic Chronic alcoholism, diabetes mellitus, malnutrition
Obstetric/Gynecologic Fragile X syndrome
Oncologic No underlying causes
Ophthalmologic Amblyopia, arteriosclerosis, astigmatism, cerebral palsy, convergence insufficiency, cycloplegia, decompression sickness, diabetes mellitus, Down syndrome, eye strain, Fragile X syndrome, hyperopia, inability of the ciliary body to contract, influenza, measles, mild traumatic brain injury, multiple sclerosis, myasthenia gravis, myopia, myotonic dystrophy, ocular inflammation, presbyopia, pseudomyopia, sclerosis of the crystalline lens, senile cataract, spasm of accommodation, thyroid disease, uveitis
Overdose/Toxicity No underlying causes
Psychiatric Down syndrome, multiple sclerosis
Pulmonary Decompression sickness, influenza, measles, myasthenia gravis, whooping cough
Renal/Electrolyte Diabetes mellitus, Down syndrome
Rheumatology/Immunology/Allergy Myasthenia gravis
Sexual Fragile X syndrome, multiple sclerosis
Trauma Head trauma, mild traumatic brain injury, whiplash injuries
Urologic Multiple sclerosis
Miscellaneous Aging, altitude, extreme fatigue, eye strain, high stress, idiopathic, multiple sclerosis, video display terminals (VDT) users

Causes in Alphabetical Order

[1][2][3][4][5]

References

  1. ↑ Duke-Elder S. System of Ophthalmology, vol V Ophthalmic Optics and Refraction. St Louis, Mosby, 1970 451- 486.
  2. ↑ Cooper J. Accommodative dysfunction. In: Amos JF. Diagnosis and management in Vision Care. Boston: Butterworths, 1987 431-54.
  3. ↑ Daune A. Anomalies of Accommodation clinically considered. Trans Am Ophthalmol Soc. 1913 1 386- 400.
  4. ↑ Scheiman M, Wick B. Clinical management of binocular vision: Heterophoric, Accommodative, and Eye movement disorders. 2nd ed. Philadelphia: Lippincott Williams and Wilkins, 2002: 334-369.
  5. ↑ Daum KM. Accommodative insuffi ciency. Am J Optom Physiol Opt 1983a 60 352-359.
  6. ↑ 6.0 6.1 6.2 Roche O, Roumes C, Parsa C (2007). "[Techniques for measuring phakic and pseudophakic accommodation. Methodology for distinguishing between neurological and mechanical accommodative insufficiency]". J Fr Ophtalmol. 30 (9): 953–60. PMID 18046282.
  7. ↑ Lieppman ME (1981). "Accommodative and convergence insufficiency after decompression sickness". Arch Ophthalmol. 99 (3): 453–6. PMID 7213164.
  8. ↑ Amin VR, Maino DM (1995). "The fragile X female: a case report of the visual, visual perceptual, and ocular health findings". J Am Optom Assoc. 66 (5): 290–5. PMID 7629369.
  9. ↑ Ohtsuka K, Maekawa H, Takeda M, Uede N, Chiba S (1988). "Accommodation and convergence insufficiency with left middle cerebral artery occlusion". Am J Ophthalmol. 106 (1): 60–4. PMID 3394770.
  10. ↑ http://www.rehab.research.va.gov/jour/10/473/Green.html
  11. ↑ Matsui M, Enoki M, Matsui Y, Oono S, Ohta M, Suenaga A; et al. (1995). "Seronegative myasthenia gravis associated with atonic urinary bladder and accommodative insufficiency". J Neurol Sci. 133 (1–2): 197–9. PMID 8583227.
  12. ↑ Daum KM (1983). "Accommodative dysfunction". Doc Ophthalmol. 55 (3): 177–98. PMID 6884172.
  13. ↑ Magnus JH, Elverland HH, Olsen EG, Husby G (1993). "Facial palsy and partial accommodative insufficiency associated with sulphasalazine treatment in a patient with ankylosing spondylitis". Scand J Rheumatol. 22 (4): 199–201. PMID 8102809.
  14. ↑ Scheiman M (1996). "Accommodative and binocular vision disorders associated with video display terminals: diagnosis and management issues". J Am Optom Assoc. 67 (9): 531–9. PMID 8888886.

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