Diagnostics and restorative treatment of accommodation astenopia from the position of applied methods, effectiveness and staging: systematic review

A systematic review was performed using the RSCI and PubMed databases, with the following search keywords: “accommodation”, “asthenopia”, “computer vision syndrome”, “quality of life”, “visual performance”. The sources were selected according to the criteria of prospective or retrospective studies. A total of 614 sources were analyzed with further use of the systematic review filters and the authors’ knowledge on the topic. To date, the following main patterns of diagnosing accommodative asthenopia (AA) in patients with visually-strained work (VSW): criteria related to objective (accommodography), subjective (quality of life), and ophthalmo-ergonomic parameters of the visual system; a personalized approach to AA diagnostics, considering habitual excess accommodation tension (HEAT) and asthenic form of accommodative asthenopia (AFAA) as separate functional disorders; a comprehensive approach to AA diagnostics, considering the occurrence of this disorder in combination with functional disorders of psychological adaptation, which are associated with the stressful nature of professional activity. Along with this, the following patterns of therapeutic and preventive measures for patients with VSW with AA phenomena are determined: the leading place is occupied by the effect of low-energy laser radiation and magnetophoresis, as well as optical-reflex training. The basis for adequate AA treatment is to determine the form of this functional disorder (PINA or AFAA). The choice of restorative treatment is based on the proposed methodological principles (personalization, complexity, consistency, standardization, repeatability), as well as time and amplitude parameters of the impact of physical factors on the accommodative system of the eye. To improve the effectiveness of restorative treatment of accommodative disorders in individuals with VSW with AA phenomena, a multidisciplinary syndrome-pathogenetic approach to the use of physical methods is necessary.