Pseudomyopia
Pseudomyopia occurs when a spasm of the ciliary muscle prevents the eye from focusing in the distance, sometimes intermittently.
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It can be organic or functional in origin.
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Pseudomyopia may be either organic, through stimulation of the parasympathetic nervous system , or functional in origin, through eye strain or fatigue of ocular systems.
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It is common in young adults after a change in visual requirements.
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It is common in young adults who have active accommodation , and classically occurs after a change in visual requirements, such as students preparing for an exam, or a change in occupation.
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Intermittent blurring of distant vision after prolonged near work is the main symptom.
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Intermittent blurring of distant vision after prolonged near work is the main symptom of pseudomyopia.
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Asthenopia
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Asthenopia
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Headache
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Headache
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Eyestrain
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Eyestrain
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Photophobia
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Photophobia
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Acute onset esotropia may occur.
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Acute onset esotropia may occur in accommodative spasm, which is the common cause of pseudomyopia.
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Diplopia may occur due to esotropia or convergence spasm.
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Diplopia may occur due to esotropia or convergence spasm
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Diagnosis is done by cycloplegic refraction using strong cycloplegic eye drops.
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The diagnosis is done by cycloplegic refraction using a strong cycloplegic like atropine or homatropine eye drops.
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Diagnosis is based on clinical evaluation demonstrating a discrepancy between refractive error measured under normal viewing conditions and after relaxation of accommodation.
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The diagnosis of pseudomyopia is based on clinical evaluation demonstrating a discrepancy between refractive error measured under normal viewing conditions and that measured after relaxation of accommodation.
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A key diagnostic feature is the reduction or elimination of myopic refractive error following cycloplegia.
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A key diagnostic feature is the reduction or elimination of myopic refractive error following cycloplegia, achieved through the administration of cycloplegic agents (such as cyclopentolate or atropine), which temporarily paralyze the ciliary muscle.
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If distance vision improves and refractive error decreases under cycloplegia, it is distinguished from true myopia.
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If distance vision improves and the measured refractive error decreases or resolves under cycloplegia, the condition is distinguished from true myopia.
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Additional findings may include fluctuating visual acuity, variable refraction results, and signs of accommodative spasm on dynamic retinoscopy.
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Additional diagnostic findings may include fluctuating visual acuity, variable refraction results between examinations, and signs of accommodative spasm on dynamic retinoscopy.
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Ocular biometry typically reveals a normal axial length.
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Ocular biometry typically reveals a normal axial length, supporting the absence of structural myopic changes.
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Diagnosis requires differentiation from early or low-grade true myopia, accommodative insufficiency, and other causes of transient visual blur.
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Diagnosis requires differentiation from early or low-grade true myopia, accommodative insufficiency, and other causes of transient visual blur.
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Treatment is dependent on the underlying aetiology.
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Treatment is dependent on the underlying aetiology .
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Organic causes may include systemic or ocular medications, brain stem injury, or active ocular inflammation such as uveitis.
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Organic causes may include systemic or ocular medications, brain stem injury, or active ocular inflammation such as uveitis .
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Functional pseudomyopia is managed through modification of working conditions, updated refraction, or ocular exercises.
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Functional pseudomyopia is managed through modification of working conditions, an updated refraction, typically involving a reduction of a myopic prescription to some lower myopic prescription, or through appropriate ocular exercises.
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Comprehensive ophthalmologic examination is recommended to exclude underlying ocular or neurologic pathology.
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Comprehensive ophthalmologic examination is recommended to exclude underlying ocular or neurologic pathology.
| Pseudomyopia | |
|---|---|
| Specialty | Ophthalmology Optometry |
| Symptoms | Blurring of vision, asthenopia |
Pseudomyopia (from ψεῦδο, "pseudo": false; and μυωπία "myopia": near sight) occurs when a spasm of the ciliary muscle prevents the eye from focusing in the distance, sometimes intermittently; this is different from myopia which is caused by the eye's shape or other basic anatomy. Pseudomyopia may be either organic, through stimulation of the parasympathetic nervous system, or functional in origin, through eye strain or fatigue of ocular systems. It is common in young adults who have active accommodation, and classically occurs after a change in visual requirements, such as students preparing for an exam, or a change in occupation.
The following symptoms may be seen in patients with pseudomyopia
- Blurring of distance vision: Intermittent blurring of distant vision after prolonged near work is the main symptom of pseudomyopia.
- Asthenopia
- Headache
- Eyestrain
- Photophobia[1]
- Esotropia: Acute onset esotropia may occur in accommodative spasm, which is the common cause of pseudomyopia.[2]
- Diplopia: Diplopia may occur due to esotropia or convergence spasm
The diagnosis is done by cycloplegic refraction using a strong cycloplegic like atropine or homatropine eye drops. Accommodative amplitude and facility may be reduced as a result of the ciliary muscle spasm.[citation needed]
There is a close correlation between unaided distance visual acuity and myopia; however, this correlation is not maintained in the presence of pseudomyopia, while pseudomyopia maybe presented as decrement of distance visual acuity.[citation needed]
The diagnosis of pseudomyopia is based on clinical evaluation demonstrating a discrepancy between refractive error measured under normal viewing conditions and that measured after relaxation of accommodation. Patients typically present with intermittent blurred distance vision, often following prolonged near work, while near vision remains relatively preserved.
A key diagnostic feature is the reduction or elimination of myopic refractive error following cycloplegia, achieved through the administration of cycloplegic agents (such as cyclopentolate or atropine), which temporarily paralyze the ciliary muscle. If distance vision improves and the measured refractive error decreases or resolves under cycloplegia, the condition is distinguished from true myopia.
Additional diagnostic findings may include fluctuating visual acuity, variable refraction results between examinations, and signs of accommodative spasm on dynamic retinoscopy. Ocular biometry typically reveals a normal axial length, supporting the absence of structural myopic changes.
Diagnosis requires differentiation from early or low-grade true myopia, accommodative insufficiency, and other causes of transient visual blur. Comprehensive ophthalmologic examination is recommended to exclude underlying ocular or neurologic pathology.
Treatment is dependent on the underlying aetiology. Organic causes may include systemic or ocular medications, brain stem injury, or active ocular inflammation such as uveitis. Functional pseudomyopia is managed through modification of working conditions, an updated refraction, typically involving a reduction of a myopic prescription to some lower myopic prescription, or through appropriate ocular exercises.[citation needed]
- ↑ García-Montero, M.; Felipe-Márquez, G.; Arriola-Villalobos, P.; Garzón, N. (2022). "Pseudomyopia - symptoms". Vision (Basel). 6 (1): 17. doi:10.3390/vision6010017. PMC 8950661. PMID 35324602.
- ↑ Hussaindeen, Jameel Rizwana; Mani, Revathy; Agarkar, Sumita; Ramani, Krishna Kumar; Surendran, Thandalam Sundararajan (2014). "Acute Adult Onset Comitant Esotropia Associated with Accommodative Spasm". Optometry and Vision Science. 91 (4): S46–S51. doi:10.1097/OPX.0000000000000182. PMID 24584303.
- Chan R, Trobe J (2002). "Spasm of accommodation associated with closed head trauma". J Neuroophthalmol. 22 (1): 15–7. doi:10.1097/00041327-200203000-00005. PMID 11937900. S2CID 10768702.
- Chentsova O, Shatalov O (2002). "Comparative analysis of the efficacy of some methods of conservative treatment of accommodation spasms and myopia in children". Vestn Oftalmol. 118 (6): 10–2. PMID 12506647.