Walsh & Hoyt: Accommodation Spasm and Spasm of the Near Reflex

Accommodation spasm is due to excessive activity of the ciliary muscle that results in an abnormally close point of focus. Clinically, there is an apparent or increased myopia that disappears following cycloplegia (pseudomyopia). Accommodation spasm typically affects both eyes, but unilateral cases have been reported. It can occur in isolation as pseudomyopia or in association with convergence spasm and excessive pupillary miosis in varying combinations and degrees, all of which probably represent the spectrum of clinical presentations of spasm of the near reflex.