Predisposition of 7–10-year-old children to accommodative spasm – findings from studies on the quality of binocular vision

Lidia Puchalska-Niedbał, Urszula Kulik, Damian Czepita


Introduction: The aim of our study was to evaluate the quality of binocular vision among school children and to indentify symptoms associated with accommodation.

Materials and methods: This study involved 300 children, aged 7–10 years. Two parts were planned: a) a questionnaire – an interview regarding problems associated with accommodative spasm; b) ophthalmic – visual acuity, anterior segment and fundus examination, auto-refractometry, motility and alignment of the eyes, dissociated horizontal phoria to near and distance using the Maddox test. The obtained results were analyzed statistically using Statistica 10 software. P values of <0.05 were considered statistically significant.

Results: The following refractive errors were selected: emmetropia (52 children), hyperopia (9 children), myopia (239 children). Degree of spasm achieved: 10 children (3.5–8 SD). The majority 

of patients showed exophoria (near – 240 children; far – 112 children). The exophoria readings were 5–12 PD. Among children with good visual acuity equal to 1.0 (218 children) exophoria was noted in 180 children; p = 0.29307. A lack of convergence was most often observed among children with near exophoria (158 children); p = 0.14929.

Conclusions: Complaints in the form of headaches or ocular pain were provided by children among whom dissociated horizontal phoria were different from the assumed norms. Difficulties concentrating while reading or symptoms of asthenopic character were reported most frequently by children with abnormal values of dissociated phoria, which may predispose them to accommodative spasm.


skurcz akomodacji; heteroforia; krótkowzroczność; dzieci

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