[Unilateral accommodation spasm: a diagnostic pitfall!].
BACKGROUND
Accommodation-convergence spasm (spasm of the near reflex) is usually bilateral, resulting in increased myopia, convergence, and miosis. Unilateral spasm of accommodation has rarely been reported.


METHODS
We investigated three females (age range 10-19 years) referred for investigations of retrobulbar optic neuritis (2 cases) and decompensated esophoria (1 case).


RESULTS
They all presented unilateral spasm of accommodation with visual loss due to increased myopia (-3.5 to -11.75 diopters). Apart from that, results of neuro-ophthalmological examination were normal.


CONCLUSIONS
Unilateral accommodation spasm is rare and can mimic retrobulbar optic neuritis and convergent strabismus. The three components of the accommodation-convergence spasm may not always be present simultaneously. Recognizing such an entity is important to prevent the patient from useless, costful and potentially harmful investigations.
Service Universitaire d'Ophtalmologie, Hôpital Jules Gonin Lausanne.
O
O
Bernasconi
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FX
Borruat
D000065:Accommodation, Ocular / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D002648:Child; D003290:Convergence, Ocular / Q000502:physiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009216:Myopia / Q000209:etiology* / Q000503:physiopathology; D013035:Spasm / Q000209:etiology* / Q000503:physiopathology; D013285:Strabismus / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology