Session: Poster session A

Treatment of Accommodative Spasm in Adulthood and Childhood

Objective: To show the results in patients treated for accommodative spasms in childhood and adulthood.

Method: An ophthalmologic examination using a 1% cyclopentolate solution was completed in a case series that included 2 children and 3 adults. Each of them was diagnosed and treated with cyclopentolate 1% due to accommodative spasm. One of the adults had strabismus and another adult, with high anisometropia and latent hyperopia, manifested spasm after Lasik refractive surgery. Examination, treatment, and outcome data were collected in each case.

Results: Measurement of visual acuity with correction under cyclopentolate helped to confirm the diagnosis. One month after treatment with cyclopentolate, three of the patients recovered their visual acuity to 100%. In the case of the patient with accommodative spasm and strabismus, and in the patient with spasm after refractive surgery, the improvement in visual acuity was partial after the first month of treatment and improved thereafter.

Conclusions: The measurement of subjective refraction with 1% cyclopentolate helps in the diagnosis of accommodative spasm. Total correction of refraction and treatment with cyclopentolate 1% can be considered an alternative in the resolution of accommodative spasms. It is confirmed that patients with latent hyperopia may present an accommodative spasm after Lasik surgery.  It is necessary to use cyclopentolate 1% for the measurement of refraction before the Lasik intervention, even in several previous controls. Confirming the diagnosis of accommodative spasm after refractive surgery with 1% cyclopnetolate allows us to avoid re-surgery.