{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:15:55Z","timestamp":1791224155243,"version":"4.1.0"},"reference-count":18,"publisher":"Czech Society of Ophthalmology of the CzMA","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CSO"],"published-print":{"date-parts":[[2023,3,30]]},"abstract":"<jats:p>Introduction: Spasm of the near reflex usually includes accommodative spasm, esophoria\/tropia, and different degrees of miosis. Patients usually refer to distance blurred and fluctuating vision, ocular discomfort, and headaches. The diagnosis is established with refraction with and without cycloplegia; most of the cases have a\u00a0functional etiology. However, some cases require neurological conditions to be ruled out; cycloplegics have an important diagnostic and therapeutic role.\nPurpose: To describe a\u00a0case of bilateral severe accommodative spasm in a\u00a0healthy 14-year-old teenager. \nCase presentation: A\u00a014-year-old boy with progressive diminished visual acuity attended for YSP consultation. The diagnosis of bilateral spasm of the near reflex was made, based on a\u00a0gap refraction of 9.75 D between retinoscopy with and without cycloplegia and esophoria with normal keratometry and axial length. The spasm was eliminated with 2 drops of cycloplegic in each eye separated by 15 days; no clear etiology was found other than the start of school.\nConclusion: Clinicians should be aware of pseudomyopia, especially in children with acute changes in visual acuity, who are usually exposed to myopigenic environmental factors that induce overstimulation of the parasympathetic third cranial nerve\u2019s\u00a0innervation.<\/jats:p>","DOI":"10.31348\/2023\/15","type":"journal-article","created":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T12:45:55Z","timestamp":1688820355000},"page":"97-100","source":"Crossref","is-referenced-by-count":2,"title":["Severe near Reflex Spasm in a Healthy Teenager. A Case Report"],"prefix":"10.31348","volume":"79","author":[{"given":"Germ\u00e1n Alberto","family":"Mej\u00eda Salgado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Guevara Carvajal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmina","family":"Salgado Paez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Tello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16213","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Goldstein JH, Schneekloth BB. Spasm of the near reflex: A spectrum of anomalies. 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Arch Soc Esp Oftalmol. 2019;94(6):285-287.","DOI":"10.1016\/j.oftal.2019.01.010"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Hughes FE, Treacy MP, Duignan ES, Mullaney PB. Persistent pseudomyopia following a whiplash injury in a previously emmetropic woman. Am J Ophthalmol Case Rep. 2017;8:28-30.","DOI":"10.1016\/j.ajoc.2017.09.006"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Dagi LR, Chrousos GA, Cogan DC. Spasm of the Near Reflex Associated with Organic Disease. Am J Ophthalmol. 1987;103(4):582-585.","DOI":"10.1016\/s0002-9394(14)74283-7"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Kara H, Yasar E, Gurlevik U. Is pseudomyopia associated with anxiety and related disorders? Pak J Med Sci [Internet]. 2021; 37[5]. Available from: http:\/\/pjms.org.pk\/index.php\/pjms\/article\/view\/3991","DOI":"10.12669\/pjms.37.5.3991"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Khalid K, Padda J, Pokhriyal S, et al. Pseudomyopia and Its Association With Anxiety. Cureus [Internet]. 202; Available from: https:\/\/www.cureus.com\/articles\/68472-pseudomyopia-and-its-association-with-anxiety","DOI":"10.7759\/cureus.17411"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"McMurray CJ, Burley CD, Elder MJ. Clear lens extraction for the treatment of persistent accommodative spasm after head trauma. J Cataract Refract Surg. 2004 Dec;30(12):2629-2631.","DOI":"10.1016\/j.jcrs.2004.05.049"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Roy S, Bharadwaj SR, Patil-Chhablani P, Satgunam PN. Spasm of near reflex: a comprehensive management protocol and treatment outcomes. 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