Monthly Archives: August 2014

accommodative dysfunction

Accommodative Dysfunction: An Often Overlooked Vision Problem That Makes Classroom Learning Difficult

The Visual Learning Center offers 
developmental optometry & vision therapy
near Silver Spring, MD in Olney.

Accommodative dysfunction is an often-overlooked functional vision problem that makes classroom learning difficult and interferes with performance in school. When parents contact us at the Visual Learning Center, they often wonder how their child could have a vision problem that interferes with learning when their family eye doctor or school vision screening did not detect anything wrong with the child’s eyesight.

We understand that, as a parent, you rely on professionals to diagnose problems and advise you on the best course of action to help your child. But the eye doctor who examined your child is probably not trained in developmental optometry, functional vision care, or vision therapy. Their job is primarily to check for eye health and prescribe eyeglasses as needed.

The visual system is complex and routine vision screenings do not mimic the classroom environment. To do their assignments and follow lessons in a classroom setting, students must sustain visual focus over extended periods of time and shift focus from one place to another throughout the day.

If your child sees the board clearly and sees the paper on their desk clearly, they may pass a typical screening with 20/20 eyesight. But everyday classroom tasks require vision skills beyond a quick glance at an eye chart. In order to complete their schoolwork, a child has to maintain focus on their books or papers long enough to read paragraphs and pages of text. And while in the classroom, students have to focus on the board long enough to follow the lesson and look back and forth between the board and their paper to copy notes.

Weak accommodative facility refers to difficulty with visual focus. In normal healthy vision, a child can sustain visual focus for an extended period and shift focus as needed from near to far and back to near again. If our visual system is functioning as it should, we don’t even think about maintaining focus or focusing our eyes as we move them. Focusing happens automatically and almost instantaneously without much effort.

But what happens automatically for most of us takes strained effort in someone with accommodative dysfunction. The “focusing” (ciliary) muscle must expand and contract efficiently to change the shape or curvature of the lense as needed to see clearly. 

If your child is struggling with accommodative facility, the focus mechanism in their visual system is either not fully developed or has been weakened. While reading, their eyes may lose focus over time, causing the text to become blurry. If so, they will have to strain to regain focus again and again, leading to fatigue and frustration. While copying from the board or from a book to a page, the focus adjustment period is slower than normal, which is also frustrating.

Signs or symptoms of accommodative dysfunction include:

  • Complaining of blurred or fuzzy vision, especially towards the end of the day
  • Rubbing, squinting eyes, or closing eyes while reading
  • Missing more questions at the end of a test
  • Copying from the board slowly or with lots of mistakes
  • Poor attention span, fidgeting, and behaviors often mistaken for ADD/ADHD
  • Bending close or bobbing and tilting head while reading
  • Headaches or aching eyes
  • Avoiding reading or near work, especially with small print

Simple tasks that come easily to their classmates are challenging and tiring for students with accommodative dysfunction. They may work slowly and become discouraged with their pace and progress in comparison to their peers.   

If you suspect your child might have trouble with visual focusing, schedule a functional vision exam with an optometrist trained in developmental vision care right away. If diagnosed, vision therapy treatment can result in significant improvement in a relatively short period of time.

If your family is located in Olney or Silver Spring, Maryland, contact the Visual Learning Center today to schedule a functional vision exam with our developmental optometrist, Dr. Philip Nicholson.

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