ABSTRACT
PURPOSE: To evaluate changes in the degree of pseudomyopia and prognosis in patients with convergence spasm and acquired pseudomyopia. METHODS: The medical records of patients with convergence spasm and acquired pseudomyopia at the Korea University Medical Center from 2011 to 2014 were identified. We reviewed the patients' gender, age, onset time, visual acuity, refractive error, angle of strabismic deviation and the selected management (cycloplegics, patching, cycloplegics + patching, prism glasses). RESULTS: At the first medical examination, the mean age was 20.08 years. The mean spherical equivalent was -3.75 diopter (D) in the right eye and -4.03 D in the left eye based on manifest refraction and -2.59 D in right eye and -2.85 D in left eye using cycloplegic refraction. Eleven of 12 patients had esodeviation with a mean esodeviation of 10.42 D. The pupil size was 3.63 mm in the right eye and 3.63 mm in the left eye. No patient experienced severe miosis (pupil size <2 mm). Observation (5), patching (3), cycloplegics (2), patching + cycloplegics (1) and prism (1) management were performed in 12 patients. Outcomes included completely cured (3), improvement (7) and no change or recurrence (2). CONCLUSIONS: Active management is necessary for patients with convergence spasm and acquired pseudomyopia.
Subject(s)
Humans , Academic Medical Centers , Esotropia , Korea , Medical Records , Methods , Miosis , Mydriatics , Prognosis , Pupil , Recurrence , Refractive Errors , Spasm , Visual AcuityABSTRACT
We report a case of early resolution of convergence spasms following the addition of antipsychotic medications and present it as a possible alternative to the conventional treatment for convergence spasms. The cessation of atropinization of the eyes and the use of reading glasses was achieved after only 2 months following the initiation of antipsychotic medications for childhood emotional disorder.
Subject(s)
Child , Female , Humans , Affective Symptoms/drug therapy , Anti-Anxiety Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Diazepam/therapeutic use , Fixation, Ocular , Selective Serotonin Reuptake Inhibitors/therapeutic use , Sertraline/therapeutic use , Treatment Outcome , Visual AcuityABSTRACT
PURPOSE:We report a case of convergence spasm that occurred after head trauma. CASE SUMMARY: A 18-year-old female presented with intermittent diplopia and decreased vision shortly after head trauma. Her past medical history was non-specific, except myopia in the left eye. On the initial examination, her uncorrected visual acuity and was variable (0.1~1.2 in the right eye, 0.05~0.1 in the left), but the corrected visual acuity was 1.2 in both eyes. Manifested refraction was also variable (-0.50~-5.50 diopters (D) in the right eye, -4.50~-6.50D in the left eye). Cycloplegic refraction was -0.50D in the right eye, and -4.50D in the left eye. The patient showed a variable esotropia (4~16 prism diopters (PD) at distance, 4~30PD at near). There was no limitation on abduction. There was no abnormality in the brain MRI. Five months after the initial visit, diplopia and blurred vision persisted.
Subject(s)
Adolescent , Female , Humans , Brain , Craniocerebral Trauma , Diplopia , Esotropia , Eye , Head , Myopia , Spasm , Vision, Ocular , Visual AcuityABSTRACT
PURPOSE: To determine changes in the degree of pseudomyopia and convergence in patients with spasm of the near reflex. METHODS: In 5 patients with spasm of the near reflex, we checked following: UCVA/BCVA, the degree of pseudomyopia revealed through manifest and cycloplegic refraction tests, pupil size, limitation of EOM, the amount of convergence defined by the alternate prism cover test, and slit lamp and funduscopic exams. RESULTS: Of the 5 patients with spasm of near reflex, 3 had accommodative spasm alone and 2 had accommodative spasm, convergence spasm and miosis. The patients' degrees of pseudomyopia and convergence were -8.0D and 14PD on the average. which disappeared after an average of 10.8 months but recurred in 1 of the 3 patients with accommodative spasm. As for spasm of the near reflex, 1 patient showed improvement in convergence but worsening pseudomyopia during the follow-up period, and another patient showed recurrence. CONCLUSIONS: The most common clinical feature of spasm of the near reflex is accommodative spasm. Patients with accommodative spasm alone showed better prognosis among all patients with spasm of the near reflex in terms of recurrence and the disease course.