Walsh & Hoyt: Nonorganic Disturbances of Accommodation

The role of accommodation spasm in the condition called spasm of the near-reflex is discussed above. In addition, however, nonorganic weakness or paralysis of accommodation may occur, primarily in children and young adults. Such patients are unable to read unless provided with an appropriate plus lens, and even then may claim an inability to read clearly. Indeed, it is the failure of a patient with normal distance vision and an inability to read despite an appropriate reading aid that should alert the physician to the possibility that the condition is nonorganic.