Accommodation is the ability of the eye to change visual focus between distant and near objects and can be referred to as your “eye-focusing” system. Muscles inside the eye (called the ciliary muscles) change the shape of the lens to allow for clarity of objects at varying distances. This system tends to break down around the age of 40, which is when most adults find themselves needing reading glasses for near work.

Concussions (or traumatic brain injuries) can lead to dysfunctions of the accommodative system. Common accommodative dysfunctions include accommodative insufficiency and accommodative excess.
Accommodative insufficiency occurs when the ciliary muscles have difficulty contracting or sustaining contraction while the eyes are focusing at near. This often leads to blurred vision with near-associated work such as reading, writing, or computer use.
Accommodative excess occurs due to sustained or over-recruitment of the ciliary muscles. This often leads to blurred vision when viewing distant and/or near objects.
  • Difficulties with activities that require extremely good focus, such as reading
  • Blurry vision (distance and/or near)
  • Eyestrain after focusing for a short period of time
  • Headaches after focusing for a short period of time
  • A pulling or tugging sensation around the eyes
  • Floating, swimming, or moving words
  • Reduced comprehension for time spent reading
  • Fatigue or sleepiness when reading
  • Difficulty concentrating when reading
  • Avoidance of reading
  • Difficulty changing focus between distance and near
A comprehensive eye examination with assessment of binocular visual function are required to diagnose accommodative dysfunctions. It is important to note that a person with an accommodative dysfunction can still have 20/20 vision, therefore difficulties in this system can be overlooked by visual screenings.
Glasses for reading or anti-fatigue lenses may be prescribed to reduce the symptoms associated with accommodative dysfunction. It is important to note that although these glasses can relieve symptoms, they are not a “cure”. Studies show that vision therapy is the best treatment for accommodative dysfunctions and other concussion-related vision problems. In this doctor-oriented, individualized treatment program, eye exercises are provided to retrain the accommodative system to contract and relax appropriately, therefore reducing or eliminating symptoms experienced from an accommodative disorder.
If you need a little bit of help with visual issues post-concussion, and are looking for sports physiotherapy in Vaughan or physiotherapy in Markham, our Thornhill location is conveniently located at the border. For those in the north looking for help, we have a location for physiotherapy in Aurora, Ontario. Our team specializes in vision rehabilitation post-concussion.
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