Symptomatic accommodative disorders and asthenopia: Prevalence and association in Ghanaian children

Background: There is a scarcity of data on asthenopia and accommodative disorders in children in Ghana as optometrists sometimes fail to carry out comprehensive assessments because of the lack of appropriate instruments. Aim: To establish the prevalence of asthenopic symptoms and symptomatic accommodative disorders among Junior High School children in Cape Coast metropolis (in their habitual vision state) and to investigate if there are any associations between asthenopic symptoms and the disorders. Method: A prospective cross-sectional school-based study using a multistage sample of 627 participants aged 12-17 years from Junior High Schools in Cape Coast metropolis, Ghana, was conducted. Participants completed a reliable asthenopic symptoms questionnaire (Cronbach's alpha = 0.866), and 220 participants who expressed two or more severe or very severe symptoms were selected for comprehensive accommodative system assessment over their habitual vision state. Results: The prevalence of symptoms of asthenopia (two or more severe or very severe) and symptomatic accommodative disorders were 35.1% and 17.4% respectively. For specific symptomatic accommodative disorders, the prevalence was as follows: 7.7% accommodative insufficiency, 4.5% accommodative infacility, 1.4% accommodative excess and 3.8% accommodative fatigue. There were significant associations between some specific accommodative disorders and some specific asthenopic symptoms even though these asthenopic symptoms overlapped in other accommodative disorders. Conclusion: Specific asthenopic symptoms do not discriminate between the presences of specific types of accommodative disorders. A comprehensive accommodative system assessment with appropriate instruments is relevant to the diagnosis and management of accommodative disorders to relieve asthenopic symptoms.