accommodative spasm

Accommodative spasm, also known as accommodative dysfunction or convergence insufficiency, can manifest in various ways. Here are the common signs and symptoms:

• Reduced distance and near vision: People with accommodative spasm may experience difficulty seeing objects clearly at both far and near distances [10].
• Frontal headache: A frequent symptom of accommodative spasm is a headache that occurs when focusing on close work or reading for extended periods [11].
• Sensitivity to light or glare: Individuals with accommodative spasm may feel uncomfortable in bright lighting conditions, which can exacerbate their symptoms [11].
• Eyestrain during close work: Prolonged focus on near tasks can lead to eye fatigue and discomfort in individuals with accommodative spasm [10].
• Variation in visual acuity at a distance: People with accommodative spasm may experience fluctuations in their ability to see objects clearly at different distances [11].
• Decreased retinoscopic reflex: A smaller or absent retinoscopic reflex can be an indication of accommodative spasm [11].
• Smaller pupil: In some cases, the pupils of individuals with accommodative spasm may appear smaller than normal [11].

These symptoms can vary in severity and may be triggered by factors such as stress, prolonged near work, or fatigue. If you're experiencing any of these symptoms, it's essential to consult an eye care professional for proper evaluation and treatment.

References: [10] - Symptoms commonly associated with accommodative include blurred vision, changing vision, headaches, eye strain, and difficulty concentrating. [11] - The most common symptoms of accommodative spasm include reduced distance and near vision, frontal headache, sensitivity to light or glare, and eyestrain during close work.

Accommodative spasm, also known as pseudo-myopia or ciliary spasm, can be diagnosed through various tests and examinations.

• Cycloplegic retinoscopy: This test is recommended for all patients with esophoria, esotropia, moderate to high hyperopia, and accommodative spasm. It helps to diagnose accommodation spasm by demonstrating against motion on MEM retinoscopy [2].
• Cover test: A cover test can be used to detect eso posture, indicating ongoing accommodative spasm [3]. This test is simple and can be performed in a clinical setting.
• Refraction tests: Diagnosis involves a comprehensive eye examination, including refraction tests and assessment of the eye's focusing ability [8].
• Photoscreener measurements: Photoscreener measurements can be a fast, practical, cost-effective examination method for screening patients without the need for cycloplegia [7].
• Monocular estimation method: A low plus in the monocular estimation method, adequate performance with minus lenses, and inferior performance with plus lenses signify over-accommodation, which can lead to accommodative spasm and pseudomyopia [10].

These diagnostic tests help to identify accommodative spasm and differentiate it from other conditions. It's essential to perform a thorough evaluation of orthoptics in all cases to simplify the diagnosis of accommodative excess or spasm [6].

Treatment Options for Accommodative Spasm

Accommodative spasm can be treated with various methods, including drug treatment. According to the search results, cycloplegic

Accommodative spasm, also known as ciliary spasm or pseudomyopia, can be challenging to diagnose due to its similarity with other eye conditions. The differential diagnosis for accommodative spasm includes:

• Myopia: Myopia, or nearsightedness, is a refractive error that can be mistaken for accommodative spasm. However, myopia is typically diagnosed using cycloplegic refraction, which is not effective in diagnosing accommodation spasm [10].
• Decompensated esophoria: Decompensated esophoria refers to an eye movement disorder where the eyes tend to converge excessively, leading to blurred vision and headaches. This condition can be misdiagnosed as accommodative spasm due to its similar symptoms [15].
• Divergence insufficiency: Divergence insufficiency is a condition where the eyes have difficulty moving outward, leading to double vision and eye strain. This condition can also be mistaken for accommodative spasm due to its similar symptoms [15].
• Lateral rectus palsy: Lateral rectus palsy refers to a paralysis of the lateral rectus muscle, which can lead to esotropia (crossed eyes) and other eye movement disorders. This condition can be misdiagnosed as accommodative spasm due to its similar symptoms [15].
• Ocular motor apraxia: Ocular motor apraxia is a rare condition where the brain has difficulty controlling eye movements, leading to abnormal eye movements and vision problems. This condition can be mistaken for accommodative spasm due to its similar symptoms [14].

It's essential to note that a proper diagnosis of accommodative spasm requires a comprehensive evaluation by an eye care professional, including a thorough medical history, visual acuity testing, and other diagnostic tests.

References: [10] - Accommodative excess can be misdiagnosed as myopia without cycloplegic refraction or ... [14] - Isolated convergence spasm is rare, 12-14 and isolated pupillary spasm is seldom ... [15] - A diagnosis of SNR was made because of the presence of acute acquired comitant esotropia associated with accommodative spasm. The differential diagnoses considered in this case included decompensated esophoria, divergence insufficiency, lateral rectus palsy, ocular motor apraxia, and ocular myasthenia.