Accommodative–vergence disorders in a paediatric ophthalmology clinical setting in Argentina

Alejandra Iurescia, Rafael Iribarren, Carla Lanca, Andrzej Grzybowski

Research output: Contribution to journalArticlepeer-review


Purpose: To determine the frequency of potential non-strabismic accommodative–vergence anomalies (NSAVA) and investigate associations between NSAVA, refractive errors and age among children attending a paediatric ophthalmology clinic. Methods: This study included children and adolescents aged 5–19 years attending an ophthalmology clinic with at least two follow-up visits. At their first visit, children had a comprehensive ophthalmic examination, including refractive error measurement by cycloplegic autorefraction and spectacles were prescribed if necessary. At the second visit, children had an examination of best-corrected visual acuity, convergence and accommodation to identify potential NSAVA. The relationship between age, sex, heterophoria and refractive error and potential NSAVA was assessed by a multivariable logistic regression model. Results: A total of 384 children and adolescents were evaluated. Their mean age was 10.97 ± 3.07 years and 58.9% were females. Forty-two per cent of children failed the NSAVA tests and 34.1% had myopia (≤−0.50 D). Children who failed NSAVA tests self-reported a higher proportion of reading problems (73.7%) compared to those who passed the tests (26.3%; p < 0.001). Children with self-reported reading problems were more likely to have accommodative infacility (57.9%) compared with children without (42.1%; p < 0.001). Refractive error and age were not associated with failure in NSAVA tests (p > 0.05). Conclusions: NSAVA was a frequent cause of vision problems found in a sample of children from an ophthalmology paediatric clinic. Thus, further research is necessary to understand the potential of public health policies to prevent, refer, diagnose and treat those conditions.

Original languageEnglish
JournalActa Ophthalmologica
Publication statusAccepted/In press - 2023


  • binocular vision
  • myopia
  • prevalence
  • reading


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