From the expected cases of presbyopia to less common presentations, including accommodative spasm and inertia, it is rare for an optometrist to go through a day of practice without coming across some form of accommodative condition.
Accommodative spasm, also known as accommodative excess, is caused by constant constriction of the ciliary muscle, which leads to exertion of accommodation.
Accommodative spasm usually occurs in young patients and presents with eye pain, myopia and meiosis when doing near work.
4 The patho-physiology of headache associated with prolonged computer use resides within the ocular surface abnormalities, accommodative spasms and dry eyes.
Persistent accommodative spasm
nine years after head trauma.
There have also been several case studies reporting the rare but significant and related development of persistent bilateral accommodative spasm
in individuals with TBI [21-23].
These symptoms could be the result of accommodative spasm
(Mon-Williams, Wann, & Rushton, 1993) or from the strain of too great a mismatch between the accommodative stimulus and the vergence stimulus (Wann, Rushton, & Mon-Williams, 1995); in this case, a meter angle (MA) of 0.
In cases were convergence or accommodative spasm
are suspected, a cycloplegic refraction should be carried out.
Several case studies have also reported the rare but significant development of persistent accommodative spasm
in individuals with TBI [18-20].
An "against" movement suggests accommodative spasm
(see Table 3).