Manna Prithwis, Karmakar Sourav, Bhardwaj Gaurav Kumar, Mondal Animesh
Department of Optometry and Vision Science, Amity University, Gurgaon, Haryana, India.
Eur J Ophthalmol. 2023 May;33(3):1273-1286. doi: 10.1177/11206721221136438. Epub 2022 Nov 16.
This article is about the accommodation spasm. The primary rule for near vision is ciliary muscle constriction, synchronised convergence of both eyes, and pupil constriction. Any weaknesses in these components could result in an accommodative spasm. Variable retinoscopic reflex, unstable refractive error, and lead of accommodation in near retinoscopy are common causes of spasm. We conducted a thorough literature search in the PubMed and Google Scholar databases for published journals prior to June 2022, with no data limitations. This review contains twenty-eight case reports, six cohort studies, four book references, four review articles, and two comparative studies after applying the inclusion and exclusion criteria. The majority of studies looked at accommodative spasm, near reflex spasm, and pseudomyopia. The most common causes of accommodative spasm are excessive close work, emotional distress, head injury, and strabismus. Despite side effects or an insufficient regimen, cycloplegic drops are effective in diagnosing accommodation spasm. The modified optical fogging technique is also effective and may be an option for treating accommodative spasm symptoms. Bifocals for near work, manifest refraction, base-in prisms, and vision therapy are some of the other management options. As a result, it requires a comprehensive clinical treatment strategy. This review aims to investigate the various aetiology and treatments responsible for accommodative spasm and proposes widely implementing the modified optical fogging method and vision therapy in clinics as comprehensive management to reduce the future upward trend of accommodative spasm.
本文是关于调节痉挛的。近视力的主要规律是睫状肌收缩、双眼同步集合以及瞳孔收缩。这些组成部分中的任何薄弱环节都可能导致调节痉挛。视网膜检影反射可变、屈光不正不稳定以及近距视网膜检影时调节超前是痉挛的常见原因。我们在PubMed和谷歌学术数据库中对2022年6月之前发表的期刊进行了全面的文献检索，没有数据限制。在应用纳入和排除标准后，本综述包含28篇病例报告、6项队列研究、4篇书籍参考文献、4篇综述文章和2项比较研究。大多数研究关注调节痉挛、近反射痉挛和假性近视。调节痉挛最常见的原因是过度近距离工作、情绪困扰、头部受伤和斜视。尽管有副作用或治疗方案不足，但睫状肌麻痹滴眼液在诊断调节痉挛方面是有效的。改良的光学雾视技术也有效，可能是治疗调节痉挛症状的一种选择。用于近距离工作的双焦点眼镜、显验光、底向内棱镜和视觉训练是其他一些治疗选择。因此，它需要一个全面的临床治疗策略。本综述旨在研究导致调节痉挛的各种病因和治疗方法，并建议在临床中广泛实施改良的光学雾视方法和视觉训练作为综合管理措施，以减少未来调节痉挛的上升趋势。
