Latent Hyperopia Latent hyperopia is the portion of the total hyperopia compensated for by accommodation and the tonicity of the ciliary muscle. It may be wholly or partially revealed by the use of a cycloplegic agent, but is usually not revealed by routine manifest subjective refractive procedures. Streff Syndrome is a condition in which there is an apparent accommodative dysfunction. A large accommodative lag on dynamic retinoscopy Clinical Characteristics Patients with accommodative problems often complain of reduced visual efficiency, asthenopia, and difficulty with near work. Patient adopts a close working distance, probably to attain relative magnification in order to adapt to low levels of blur.
Patient experiences an intermittent blur of vision when they go from near to distance vision.
Accommodative problems usually show up distinctly between the end of third grade and the beginning of fourth grade, when the print gets smaller. Reading achievement may begin to decline at this time. Clinical Examination Considerations History Obtain a thorough history. You need to solicit specific complaints. In many cases of accommodative dysfunction, the near visual acuity will be reduced.