Clinical profile and associations of accommodative dysfunction at a binocular vision therapy clinic of a tertiary eye centre in north India

Background: The aim of this study was to review the incidence of Accommodative dysfunctions, Clinical features, and their association with Binocular Vision disorders at a Binocular Vision Therapy Clinic of a tertiary Eye centre in North India. Methods: A retrospective study was conducted with review the record of 527 symptomatic patients with binocular vision and/or accommodative dysfunction related problems who were referred between march 2019 to march 2020, to a binocular vision therapy clinic. Patients with any ocular surgery, manifest strabismus, amblyopia, anisometropia (more than 2.00 dioptres), ocular pathology, neurological disorders &Prepresbyopic patient were not included in the review. Accommodative dysfunctions were defined and results of each of test in the record were compared with the normative values and diagnostic criterion used by F Lara et al specified in Clinical Management of Binocular Vision, by Scheiman and Wick. Results: Of the 527 symptomatic patients examined, 103 patients (19.4%) presented some kind of accommodative dysfunctions. Among the 103 accommodative dysfunction patients, 59 were females and 44 were males. Most of them diagnose with accommodative excess (37%) followed by accommodative in facility (29%), accommodative insufficiency (28%), ill sustained accommodation (5.8%) and no patients had paralysis of accommodation. Conclusion: Incident accommodative excess was more than accommodative insufficiency. A diagnosis of accommodative and/or binocular disorder depends not only on a few clinical findings of some accommodative and binocular investigations but on a whole battery of tests, in order to produce diagnosis of the type of dysfunction of the patient.