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[Unilateral accommodation spasm: a diagnostic pitfall!]

O Bernasconi1, F X Borruat

  • 1Service Universitaire d'Ophtalmologie, Hôpital Jules Gonin Lausanne.

Klinische Monatsblatter Fur Augenheilkunde
|July 25, 1998
PubMed
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Unilateral spasm of accommodation is a rare condition causing significant myopia and visual loss. It can mimic other serious eye conditions, necessitating accurate diagnosis to avoid unnecessary treatments.

Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology

Background:

  • Accommodation-convergence spasm, or spasm of the near reflex, typically presents bilaterally, leading to myopia, convergence, and miosis.
  • Unilateral spasm of accommodation is an infrequently documented clinical presentation.

Observation:

  • Three female patients (ages 10-19) were evaluated for suspected retrobulbar optic neuritis and decompensated esophoria.
  • All patients exhibited unilateral spasm of accommodation, resulting in substantial myopia (-3.5 to -11.75 diopters) and associated visual impairment.

Findings:

  • Neuro-ophthalmological examinations were otherwise unremarkable in all cases.
  • The unilateral accommodation spasm presented with significant myopic shift and visual loss.

Implications:

Related Experiment Videos

  • Unilateral accommodation spasm is a rare diagnosis that can be mistaken for retrobulbar optic neuritis or convergent strabismus.
  • Prompt recognition is crucial to prevent potentially harmful, costly, and unnecessary diagnostic procedures and treatments for misdiagnosed conditions.