Spasm of Near Reflex: Clinical presentation, near-triad behavior and vision

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Title: Spasm of Near Reflex: Clinical presentation, near-triad behavior and vision loss

Bio Dr Shrikant Bharadwaj

Bio Dr Premnandhini-satgunam

Narrative: Spasm of near reflex (SNR), also called accommodative spasm or pseudo-myopia, is encountered often by clinical optometrists specializing in orthoptics and binocular vision. Even while this dysfunction was reported by Prangen almost a century ago, a systematic documentation of the clinical profile, pathophysiology and optical management strategy are not well-known. In this talk, we will present results from a series of experiments that we have performed to understand all aforementioned aspects of this dysfunction. Our investigations reveal that, contrary to popular belief, there is no gender predisposition in SNR and nearly 80% of patients with this dysfunction can be managed by an optical fogging technique with or without a single dose of atropine eye drops. Behaviorally, SNR is characterized by significant fluctuations in the accommodative state of the eye, that putatively arise from the increased neurological tone of the accommodative system. These fluctuations in accommodation contribute significantly to the loss of vision in patients with SNR and can be used as a sensitive marker for differentiating this dysfunction, vis-a-vis, regular myopia.