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Spasm of accommodation

In general the accommodation start for adjustment system of eye while viewing near and distance object. In case of spasm of accommodation means unable to do the accommodation properly.

When a person doing there near work (reading newspaper, using mobile, watching T.V from very closely) for prolong time in that moment if they try to look at distance they couldn’t be able to focus at that distance object. The accommodation is not stable and person unable to fixed properly. This condition called spasm of accommodation.

The most important things is that, unable to focus at distance properly this condition may lead to Pseudo-myopia or latent hyperopia.

Clinical finding: Normal amplitude of accommodation and near point convergence. Reduced negative relative accommodation. Patients may complain difficulty facing plus and blur vision, but accept minus power very well.

Treatment: If we start treatment or assessment for those person in general way then we could not get the proper amount of refractive error and the patient Don’t tell the correction. Because patient phycologycally accept the worng power. For those reason we go with another way —

1) Cyclopagic Eye drops (Dialation) — The patients feel batter to accept the dilation procedure. Spasm of accommodation is cause of excessive accommodation, if we apply Homatropin 5% topically daily then the excess of accommodation can become control day by day.

Side effect — Daily use can cause error, the tear shield, all the eye drops contain certain amount of benzalkonium chalride, which contains a detergt effects disruption the lipid layer of the tear film. Rapid use cause no-longer projects of aqueous layer of the tear film and evaporate esally. If the condition continues then cornea expose to air and cause corneal deasies.

Duto high potential of tear shield disruption long period of time using it correlated with dry eye condition.

The risk factor using cyclopagic glocoma patient and cardiac patient.

2) VisiosTraining — If we start mental Counciling / therapy of that spasm of accommodation patient with symustanius drugs therapy. It’s also very much effective. This training was given by trained optometrist and we.

3) Surgery — Surgery is a last option for those case but in those do multifocal intraocular but there is a contradiction if new process but there is a contradiction if the patient had – resistant spasm of accommodation for a long period of time.

Prognosis: “American ophthalmologic Association says the prognosis is fair and on avarage”. The patient of spasm of accommodation need to 1-2 evaluation and 10 follow up visit.

Symptoms: The main symptoms is Fatigue. We thing that eye strain and fatigue are same but they are different in nature.

e strain is a symptom  by people when their eyes feel tired and achy. Some people state that they just want to close their eyes and go to bed when they have eye strain. They feel exhausted(eye get tired) . Sometimes, eye strain can give you a headache or even make you dizziness.

Ciliary Body Fatigue  

Eye strain is caused by different things. First, any time you do extended near work the ciliary body, a muscle found inside the eye, is forced to work overtime. The ciliary body is the focusing muscle and allows humans to focus on near objects. When you stare or concentrate on a new object, that muscle contracts and allows the lens to get thicker and increase the total power of the eye.

– Blurred vision depending on patients retractive status – Duto spasm we unable to focus and that’s result blurred vision. But it also depend on refractive status of our eyes. If a person have uncorrected refractive error then it is also get effect on vision and create blur vision.

– Asthenopia during close work – We unable to relax the Ciliary muscle that cause spasm of accommodation. And for that reason during near work reading or whatever they do in near. They feel asthenopia.

– Pain (Brows / Headache)

– Miosis and Macropsia – Miosis is excessive construction of pupils.

Macropsia is a neurological condition that affects the human eye visual perception.

– Convergence anomalies (excess or insufficient) 

– All symptoms of accommodative strain in excess.

Accommodative Spasm triggerd by the factors–

1) Visual overload (T.V, computer, studies in evening) 

2) Bad illumination the working place.

3) Wrong, day regimen (not enough fresh air walks, sports sleep) 

Bed sizing of table / Chair / child’s height, bad eye-to-book distance (30-35 optimum).

Weakness of neck and back muscles, blood supply disturbance in cervical spine.

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