Accommodative anomalies among schoolchildren in Abia State, Nigeria

Background: Ocular discomfort resulting from accommodative anomalies can impair reading efficiency, school performance and possibly a person’s quality of life. Aim: The aim of this study is to determine the prevalence of accommodative anomalies in schoolchildren in Abia State, Nigeria, and to assess possible associations with sample demographics such as age, gender and school level. Setting: The study was conducted in primary and secondary schools in Abia State, Nigeria. Methods: Case history questionnaires and vision tests were administered to 537 (mean age 13.0 ± 2.0 years) children randomly selected from nine schools in Abia State. The following vision parameters were measured: visual acuity, non-cycloplegic refraction, cover test, near point of convergence, fusional vergences, accommodative functions and ocular health evaluation. All accommodative and binocular function tests were performed following the subjective refraction with compensating lenses in place, if prescribed. Anomalies of interest such as accommodative insufficiency, accommodative excess and accommodative infacility were classified using the findings of accommodative and vergence parameters. Results: A total of 90 (16.8%) children had accommodative anomalies. Prevalence estimates include accommodative insufficiency (3.9%), accommodative excess (2.8%) and accommodative infacility (10.1%). There was no significant difference in the distribution of various accommodative anomalies between age group, gender or school level. Conclusion: The significant proportion (16.8%) of children with accommodative anomalies in the present study is an important finding, considering that paediatric vision screening programmes that only focus on visual acuity are unlikely to detect these critical visual anomalies. The result of this study is expected to direct the development of a common and broad vision screening strategy.