Dr.Vanshaj Rai

Dr. nikhila yadav, Dr.Aditi Parab, Dr. Akhilesh Kumar

Abstract

Accommodative spasm is a rare clinical condition due to prolonged contraction of cilliary muscles characterized by asthenopic symptoms. The objective of this case series is to highlight the importance of cycloplegic refraction to detect accommodative spasm in patients supposed to be a malingerer. Three patients, presented with complaints of sudden onset blurring of vision and asthenopic symptoms with aggravation of symptoms with prolonged near work. Initially, on refraction there was a myopic error which shifted to hypermetropic, after cycloplegia. VA was 6/6 for distance in both patients with their hyperopic correction, and N6 with up to +3.00 diopters for near. Diagnosis of accommodative spasm was made and treatment was initiated with the provision of bifocal glasses and atropinisation (1%). The therapy was gradually tapered and patients were observed for one year. An ophthalmologist must remain alert to avoid misinterpretation of presentation.