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Ophthalmology9 papers

Anomaly of vergence system

Last edited: 4/15/2026

Overview

Non-strabismic accommodative-vergence anomalies (NSAVA) refer to disruptions in the coordinated processes of accommodation and vergence, often observed in pediatric populations, potentially impacting visual function and academic performance 1.

Diagnosis

  • Comprehensive ophthalmic examination including cycloplegic autorefraction for refractive error measurement 1.
  • Assessment of best-corrected visual acuity, convergence, and accommodation tests to identify NSAVA 1.
  • Higher prevalence of NSAVA noted in children with myopia (≤-0.50 D) and self-reported reading difficulties 1.
  • Management

  • Prescription of appropriate spectacles based on refractive error correction 1.
  • Vision therapy tailored to improve accommodative and vergence skills, though specific drug classes or doses are not detailed in the provided abstracts 1.
  • Special Populations

  • Pediatrics: Higher frequency of NSAVA observed in children aged 5-19 years, with significant association between NSAVA and reading problems 1.
  • Key Recommendations

  • Conduct comprehensive ophthalmic evaluations including cycloplegic autorefraction and accommodative-vergence assessments in pediatric patients presenting with visual complaints 1 (Evidence: Moderate).
  • Prescribe corrective lenses based on refractive error findings to address myopia and potentially alleviate symptoms associated with NSAVA 1 (Evidence: Moderate).
  • Consider vision therapy for children failing NSAVA tests, particularly those reporting reading difficulties, to enhance visual function 1 (Evidence: Expert opinion).
  • References

    1 Iurescia A, Iribarren R, Lanca C, Grzybowski A. Accommodative-vergence disorders in a paediatric ophthalmology clinical setting in Argentina. Acta ophthalmologica 2024. link 2 Antonello A, D'Angelo A, Nalesso F, Capezzi M, Malagoli A, Pastori G et al.. Double urine circulation: importance of pores. Journal of nephrology 2003. link

    Original source

    1. [1]
      Accommodative-vergence disorders in a paediatric ophthalmology clinical setting in Argentina.Iurescia A, Iribarren R, Lanca C, Grzybowski A Acta ophthalmologica (2024)
    2. [2]
      Double urine circulation: importance of pores.Antonello A, D'Angelo A, Nalesso F, Capezzi M, Malagoli A, Pastori G et al. Journal of nephrology (2003)

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