Accommodative spasm (AS) is rarely reported in the literature. We studied 17 patients with accommodative spasm. Most patients were clinically emmetropic. Ten patients also manifested a spasm of the near reflex (SNR). The probable etiology of the accommodative disorder for most patients was psychogenic as revealed by case histories and visual field analysis. Treatment consisted primarily of plus reading lenses and, in some instances, orthoptic training. Some patients also underwent psychological counseling. Follow-up ranged from 2 months to 30 months. Although visual symptoms improved for most patients, only four patients had complete resolution of the spasm.