title: Traumatic myopia secondary to ciliary spasm after blunt eye trauma and reconsideration of its pathogenesis.
abstract: OBJECTIVE
  To reconsider the pathogenesis of traumatic myopia by describing two cases and literature review.
  
  
  METHODS
  Refraction was measured, A-scan ultrasonography was performed, and ultrasound biomicroscopy (UBM) was used to observe the ciliary body in the acute and recovery stages.
  
  
  RESULTS
  The first patient had a myopic shift of -6.12 diopters (D) on the initial examination (day 2) compared with the recovered stage. UBM showed ciliochoroidal effusion in one half of the circumference and severe edema in three eighths of the ciliary body, which led to an anterior rotation of the ciliary body. Immediately after the cycloplegia, the myopic shift decreased by -3.9 D. On day 11, the refraction was -0.63 D, and the UBM findings were normalized. The second patient had a myopic shift of -4.38 D on the first examination compared with the recovered stage. UBM showed an annular ciliochoroidal effusion leading to anterior rotation of the ciliary body. Immediately after the cycloplegia, there was a decrease of -2.75 D. Biometric measurements showed an increased anterior chamber depth and a decreased thickness of the lens. On day 16, the refraction was -1.0 D, and the UBM findings were normalized. In both cases, biometric measurements in the acute phase suggested a anterior chamber shallowing, a thickening of the lens, and an anterior shift of the lens-iris diaphragm
  
  
  CONCLUSIONS
  Cycloplegia decreased the myopic shift by more than 60 %. These findings indicate a significant contribution of ciliary spasm combined with ciliochoroidal effusion, anterior shift of the lens-iris diaphragm, and thickening of the lens.
authors: Department of Ophthalmology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan. nao-i@hyo-med.ac.jp.
authors: Naohiro
authors: N
authors: Ikeda
authors: Department of Ophthalmology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan.
authors: Tomohiro
authors: T
authors: Ikeda
authors: Department of Ophthalmology and Visual Science, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors: Takeya
authors: T
authors: Kohno
mesh_terms: D000293:Adolescent; D000328:Adult; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D002924:Ciliary Body / Q000000981:diagnostic imaging / Q000502:physiology*; D005131:Eye Injuries / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D033401:Microscopy, Acoustic; D009216:Myopia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology*; D013035:Spasm / Q000150:complications* / Q000503:physiopathology; D014603:Uveal Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
keywords: Anterior shift of the lens-iris diaphragm; Ciliary spasm; Ciliochoroidal effusion; Ciliochoroidal effusion syndrome; Traumatic myopia