Accommodative spasm treatable with refractive correction, surgeon says

ANAHEIM, Calif. — Accommodative spasm caused by head trauma can be treated with correction of the resulting refractive error, said Aki Kawasaki, MD.

Dr. Kawasaki discussed the signs, symptoms and causes of accommodative disorders at the American Academy of Ophthalmology meeting here.

Disorders of accommodation manifest as accommodative insufficiency or accommodative spasm. Accommodative insufficiency is often a side effect of a systemic illness and usually resolves. Accommodative spasm is a functional disorder, commonly a result of head trauma. Both conditions may result from organic midbrain lesions, he said.

“Accommodative spasm limits patients’ ability to see clearly at distance,” Dr. Kawasaki said. “Patients present with blurred vision, brow ache, fluctuation in distance vision and abduction deficit.” Pseudomyopia is also a result of accommodative spasm, observable as increased myopia on manifest reaction as compared to cycloplegic refraction.

Because near vision is severely altered during accommodative spasm, patients are benefited most by myopic correction, Dr. Kawasaki said.