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Relieving Accommodative Spasm: Two Case Reports.

Background: Relief from accommodative spasm involves a long course of pharmacological treatment and/or vision therapy. Complete resolution is challenging, especially within a short time frame. This case report demonstrates a clinical management technique that instantaneously provided relief from acc...

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Published in:Optometry & Visual Performance Vol. 6; no. 5; pp. 207 - 213
Main Author: Satgunam, Prem Nandhini
Format: case study tables/charts Journal Article
Published: Optometric Extension Program Oct2018
Online Access:View this record in EBSCOhost
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      dt: Oct2018
      vid: 6
      iid: 5
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      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Relieving Accommodative Spasm: Two Case Reports.
      aug:
        au: Satgunam, Prem Nandhini
        affil: Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, Telangana, India
      sug:
        subj:
          Ocular Physiology
          Eye Diseases Therapy
          Human
          Adolescence
          Child
          Visual Acuity
          Refractive Errors
          Atropine Therapeutic Use
          Ophthalmoscopy
          Myopia
          Hyperopia
          Vision Tests
          Male
          Adolescent: 13-18 years
          Child: 6-12 years
          Male
      ab: Background: Relief from accommodative spasm involves a long course of pharmacological treatment and/or vision therapy. Complete resolution is challenging, especially within a short time frame. This case report demonstrates a clinical management technique that instantaneously provided relief from accommodative spasm. A fogging technique modified from Borish's delayed subjective test was used to stabilize accommodation in two patients. Case Report 1: A 14-year-old male child presented with 20/200 visual acuity and variable high myopic refractive error. Cycloplegic refraction showed low hyperopia. Atropine was used for 1.5 months. Upon discontinuation of the atropine, the child again developed accommodative spasm and was referred to our vision therapy clinic. Case Report 2: A 10-year-old male child presented with 20/500 visual acuity and high myopia but showed low hyperopia upon cycloplegic refraction. At the post-cycloplegic visit, the child again exhibited accommodative spasm and was referred to our vision therapy clinic. Conclusion: A modified fogging technique can be applied to relieve accommodative spasm for patients through optical means. A cycloplegic refraction is essential to determine the refractive error initially. The modified fogging technique can be applied during the post cycloplegic visit if the spasm recurs. Stability of accommodation and improvement in visual acuity is obtained with this technique.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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