A 30 year old man has 6/5 vision each eye, unaided. His cycloplegic retinoscopy is +1.0 D sph. at 1 metre distance. His complaints are blurring of new sprint at 30 cm, that clears up in about two minutes. The most probable diagnosis is:

C i.e. Accommodative ineia Accommodative ineia (infacility) refers to delay in response of accommodation resulting in blurring of vision when distance of vision is changed from near to far or far to near. Q (Normally accommodative change occurs in 1 seconds) Anomalies of Accommodation Presbyopia Accommodative Ineia/Infacility Accommodative spasm/ excess (Pseudomyopia, Hyper accommodation) Paralysis of accommodation (Cycloplegia) Failure of Accommodation * It is not an error of * It is delay in * It is greater * It is complete absence * It can be refraction but condition response of accommodative response of accommodation - Accommodative of physiological accommodatio than is considered * Causes insufficiency which insufficiency of accommodation Q * It is physiological change appropriate for age Q * Symptoms n; which normally occurs inl second Q (in this Q taking 2 minutes) normal for a distance * Causes - Found mainly in children, who attempt to compensate his - s e.g. Dru g atropine, homatropine or other parasympatholytic is inability to exe accommodation appropriate for age (excludes presbyopia) - Gradual difficulty in performing near work paicularly in dim illumination (e.g. reading, sewing etc.) - Arms are not long enough (for increasing * The lag between the stimulus to accommodatio n & accommodativ response is e refractory error Q - Myopes are more affected than hypermetropes - Drugs which induce ciliary spasm like miotics such as - Internal opthalmoplegia (usually B/L) due to neuritis associated with diptheria Q Q, syphilis, diabetes, - Ill sustained accommodation in which the accommodation is normal initially but can not be sustained for about a minute distance) is a common experience due to difficulty in echothiophate di iso propylfluorphosphate alcoholism, cerebral or * Accommodative insufficiency is due - Asthenopic symptoms changing focus (DFP) meningeal diseaseQ to