accommodative excess

• Blurring of vision due to pseudomyopia
• Headache
• Eye strain
• Asthenopia
• Trouble concentrating when reading

Accommodative excess may be seen in the following conditions:{{cite book |author1=AK Khurana |title=Theory and Practice of Optics and Refraction |publisher=Elsevier |pages=105–106 |edition=2 |chapter=anomalies of accommodation and convergence}}

• Hypermetropia: Young hypermetropes use excessive accommodation as a physiological adaptation in the interest of clear vision.
• Myopia: Young myopes performing excessive near work may also use excessive accommodation in association with excessive convergence.
• Astigmatism: Astigmatic eye may also be associated with accommodative excess.
• Presbyopia: Early presbyopic eye may also induce excessive accommodation.
• Improper or ill fitting spectacles: Use of improper or ill fitting spectacles may also cause use of excessive accommodation.

Use of systemic drugs like Morphine, Digitalis, Sulfonamides, Carbonic anhydrase inhibitors may cause accommodative excess.{{cite book |last1=William J |first1=Benjamin |title=Borish's Clinical Refraction |publisher=Butterworth Heinmann Elsevier |pages=114–115 |edition=2 |chapter=Accommodation, the Pupil, and Presbyopia}}

• Unilateral excessive accommodation-Trigeminal neuralgia, and head trauma may cause ciliary spasm and may cause accommodative excess.
• Bilateral excessive accommodation-Diseases like Encephalitis, Syphilis, Head trauma, Influenza, Meningitis may cause ciliary spasm and bilateral excessive accommodation.

Accommodative excess may occur secondary to convergence insufficiency also. In convergence insufficiency near point of convergence will recede, and positive fusional vergence (PFV) will reduce. So, the patient uses excessive accommodation to stimulate accommodative convergence to overcome reduced PFV.{{cite book| title=Clinical Management of Binocular Vision |edition=4 |author=Mitchel Scheiman, Bruice Wick |chapter=Accommodative Dysfunction| page=357}}

A large amount of near work is the main precipitating factor of accommodative excess.

Pseudomyopia also known as artificial myopia {{cite book| title= Theory and Practice of Optics and Refraction | author= AK Khurana |edition=2| chapter= Errors of refraction and binocular optical defects| page= 77}} refers to an intermittent and temporary shift in refractive status of the eye towards myopia. It may occur due to excessive accommodation or spasm of accommodation.{{cite journal| url=https://avehjournal.org/index.php/aveh/article/view/33/409| title= A review of non-strabismic accommodative and vergence anomalies in school-age children. Part 2: Accommodative anomalies | author= Wajuihian SO, Hansraj R | journal= African Vision and Eye Health | date= 28 August 2015 | volume= 74 | issue= 1 | page= 7 }}

Parinaud's syndrome, which can mimic some aspects of spasm of the near reflex, such as excessive accommodation and convergence; however, pupillary near-light dissociation, not miosis, is a feature of Parinaud's syndrome.{{cite book| title= Current Ocular Therapy| chapter= Iris and Ciliary body | page=518| author= Frederick Hampton Roy, Frederick W. Fraunfelder, Frederick T. Fraunfelder| edition=6 }}

• Optical: Cycloplegic refraction, and correction of Refractive errors if any
• Vision therapy{{cite book| title=Clinical Management of Binocular Vision |edition=4 |author=Mitchel Scheiman, Bruice Wick |chapter=Accommodative Dysfunction| page=354}}
• General: Relax from near work

• Spasm of accommodation
• Convergence excess

{{Reflist}}

Category:Disorders of ocular muscles, binocular movement, accommodation and refraction