What happens during a spasm of accommodation
When we look into the distance, the ciliary muscle is relaxed and the lens is flattened. To read, the muscle contracts and the lens becomes convex. After close work, the muscle normally relaxes quickly. If the load lasts for hours without breaks, the muscle remains tense even after the person has raised his eyes. The eye turns out to be tuned to a close distance, and distant objects blur. Unlike true myopia, the length of the eye does not increase, so distance vision fluctuates throughout the day and improves after rest.
- Habitually excessive stress of accommodation is the most common form
- Spasm due to uncorrected farsightedness or astigmatism
- Spasm when working with small parts in adults
- Drug-induced spasm - rare
- Combination of spasm and true myopia
Causes and risk factors
The main reason is long-term visual work at close range without breaks. School loads, homework, smartphones and computer games force children's eyes to focus close for many hours on end. The situation is aggravated by weak or uneven lighting, reading while lying down and in transport, too short a distance to the text, and incorrect seating at the desk. Lack of time outside in daylight also increases the risk of myopia. Contributions include uncorrected farsightedness and astigmatism, general fatigue and lack of sleep.
- Long hours of close work without breaks
- Smartphones and tablets at close range
- Few walks in daylight
- Poor lighting, reading while lying down
- Incorrect seating and table height
- Uncorrected farsightedness and astigmatism
Symptoms
The child begins to see worse from the board, squints, comes closer to the TV, especially towards the end of the day or school term. After weekends and holidays, vision may improve. The eyes quickly get tired, turn red, there is a burning sensation and watery eyes, and there is a headache in the forehead and temples. Adults note that after working at the computer it is difficult to focus on distant objects, such as road signs. Sometimes the text blurs when reading and difficulties when looking from close to far away.
- Blurred distance vision that fluctuates throughout the day
- Squinting
- Fatigue, burning and redness of the eyes
- Headache after exercise
- Improved vision after rest
- Difficulty shifting your gaze
Diagnostics
The main diagnostic method is to determine refraction before and after cycloplegia. To do this, drops are instilled into the eyes, which temporarily relax the ciliary muscle and dilate the pupil. If after the drops myopia decreases or disappears, then the problem is a spasm. Without this research, the child may be mistakenly prescribed distance glasses, which will increase stress. Additionally, the doctor evaluates accommodation reserves, binocular vision and eye position. Ultrasound biometrics measures the length of the eye and helps monitor the development of true myopia.
- Visual acuity test
- Autorefractometry before and after cycloplegia
- Assessment of accommodation reserves
- Binocular vision study
- Ultrasound biometrics of the eye
- Examination of the anterior segment and fundus
Treatment and prevention
The basis of treatment is changing the visual mode. Every 20-30 minutes of close work, you should take a short break and look into the distance, and screen time for children should be limited. Walking daily in daylight has been proven to reduce the risk of developing myopia. The doctor may prescribe a course of drops that relax accommodation and select glasses for farsightedness or astigmatism. If the spasm is combined with true myopia, special methods are used to control its progression. Eye exercises are useful as a supplement, but do not replace the regimen and examinations.
- Take breaks every 20–30 minutes and look into the distance
- Limiting screen time
- Walk in daylight for at least 1–2 hours a day
- Good lighting and proper positioning
- Drops for relaxing accommodation as prescribed
- Correction of farsightedness and astigmatism
- Regular examinations with an ophthalmologist
