ICD Body System
Diseases of the nervous system and sense organs [320 - 389]
Date amended:
External
Statements of Principles
Current RMA Instruments

Reasonable Hypothesis SOP

21 of 2026

Balance of Probabilities SOP

22 of 2026
Changes from previous Instruments
 
ICD Coding
  • ICD-10-AM Codes: H52.5
Brief description

Accommodation disorder is a condition in which there is an inability to adjust the lens of the eye to focus on objects at different distances, or an inability to sustain such adjustment over time. This results in difficulty maintaining clear vision, particularly when shifting focus between near and distant objects. 

For the purposes of this SOP, accommodation disorder excludes conditions primarily affecting the lens or shape of the eye, including presbyopia, cataract, myopia, hypermetropia, and astigmatism. It also excludes accommodative excess and temporary (pharmacologically induced) paralysis of accommodation, unless the causative medication cannot be ceased or substituted. 

Confirming the diagnosis

The diagnosis is made on clinical grounds, based on history and examination of visual function, including assessment of accommodation and focusing ability. 

Diagnosis and management are typically undertaken by an optometrist or ophthalmologist.

Additional diagnoses covered by the SOP
  • Accommodative insufficiency
  • Accommodative infacility  
Conditions not covered by the SOP
  • Astigmatism * - Visual Refractive Error SOP
  • Cataract *
  • Hypermetropia * - Visual Refractive Error SOP
  • Myopia * - Visual Refractive Error SOP
  • Presbyopia - revoked SOP (cannot be related to service)
  • Accommodative access #
  • Reversible pharmacological paralysis of accommodation pharmacological agents (when such medications cannot be ceased or substituted)

* another SOP applies - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

Clinical onset refers to the earliest time at which symptoms consistent with impaired accommodation were first present. Because symptoms are often non-specific, it may be difficult to determine onset prior to diagnosis. Where symptoms follow a specific event, such as an injury or medication use, onset may be dated to that event. 

Clinical worsening

Clinical worsening may be indicated by a decline in accommodative function beyond that expected for age. Assessment typically requires optometrist or ophthalmologist evaluation, and management is usually conservative, most commonly with correctives lenses.