Unilateral accommodation spasm: Case report and literature review

Abstract

This case report describes a probable unilateral accommodation spasm in a 10 year-old girl with no significant medical history. The right eye showed decreased visual acuity, 0.2 to 0.6 for far distance and 0.125 for near distance. Refraction without cycloplegia showed myopization up to -6 and cycloplegic refraction of+0.50. The patient had normal ocular motility, orthophoria, normal pupil reflex, normal anterior and posterior segments, normal optical coherence tomography. Neurophysiological tests and brain magnetic resonance imaging were all normal. Treatment with atropine 1% drops for 15 days improved distance visual acuity to 0.8. Accommodation spasm is a rare condition and is usually bilateral. Imaging test are necessary because it may be associated with ocular or head trauma. Treatment consists of cycloplegic drugs (atropine, cyclopentolate); however, there is no defined guideline.

Keywords: Accommodation spasm; Atropina; Atropine; Espasmo acomodativo; Espasmo de reflejo de cerca; Pseudo-myopia; Pseudomiopía; Spasm of near reflex.