Accommodative anomalies in symptomatic school children in Cape Coast Metropolis, Ghana
Accommodative anomalies even though have been associated with an increased risk of academic failure in the pediatric population, yet have been underappreciated in African populations. This prospective cross sectional study which conformed to the Code of Ethics of the World Medical Association (Declaration of Helsinki) aimed to determine the frequencies of accommodative anomalies among symptomatic Junior High school children in the Cape Coast metropolis, Ghana.
Accommodative assessment (testing for amplitude of accommodation, accommodative lag, accommodative facility, and negative and positive relative accommodation) was conducted over best corrected refraction results in a multi-stage sample of 202 symptomatic school children age ranged 12 to 17 years old. Descriptive data was analyzed using frequencies, percentages, means and standard deviations. Binary logistic regression was used to test associations between outcome variables. Of the symptomatic participants (202) assessed, 38 (18.8%) were diagnosed with ametropia, with the most frequent type being astigmatism 19 (9.4%). A number of 104 (51.5 %) symptomatic participants were diagnosed with accommodative anomaly. The frequency of specific accommodative anomalies among symptomatic Junior High school children was as follows: accommodative insufficiency, 45 (22.3%); accommodative infacility, 22(10.9%); accommodative excess, 27(13.4%) and accommodative fatigue, 10 (5%). Participants with accommodative anomalies had greater odds of experiencing symptoms of visual fatigue associated with near work (OR =0.530, p= 0.001) compared with other symptoms. The study results indicate a high prevalence of accommodative anomalies on this symptomatic school going population in Ghana and this can impact negatively on their academic performance.
Keywords: Accommodative disorders, ametropia, asthenopic symptom, school children, Ghana