Spasm of Near Reflex: Clinical presentation, near-triad behavior and vision loss with Drs. Shrikant Bharadwaj and Premnandhini Satgunam

Spasm of Near Reflex: Clinical presentation, near-triad behavior and vision loss with Drs. Shrikant Bharadwaj and Premnandhini Satgunam

Course Description

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.

Instructors_Shrikant Bharadwaj and Premnandhini Satgunam

Instructor Bio

Shrikant Bharadwaj completed his undergraduate degree in Optometry from the Elite School of Optometry, Chennai and a PhD in Vision Science from the University of California Berkeley School of Optometry, USA. After completing his post-doctoral training in Vision Science at the Indiana University School of Optometry, USA, Dr Bharadwaj returned to the L V Prasad Eye Institute (LVPEI) in Hyderabad as a DBT Ramalingaswami Fellow in 2009. He then established the Visual Optics research laboratory at LVPEI with the overall agenda of understanding how the optics of the eye influences spatial vision and depth vision. Dr Bharadwaj uses a combination of experimental, behavioural and computational techniques to address this research agenda. His laboratory actively publishes research work in international peer-reviewed vision science journals and the research work is generously supported by extramural grants from the Government of India and the optical industry. Dr Bharadwaj also serves on the editorial board of Nature Scientific Reports, Optometry and Vision Science, PLoS One and the Indian Journal of Ophthalmology. He also serves as a peer-reviewer for almost all optometry and vision science journals. In addition to his research work, Dr Bharadwaj serves as the Network Associate Director of the Brien Holden Institute of Optometry and Vision Sciences at LVPEI. He is also actively involved in teaching undergraduate and postgraduate students of optometry at the L V Prasad Eye Institute.

 

Premnandhini Satgunam received her bachelor’s degree in optometry from the Elite School of Optometry, Sankara Nethralaya BITS, Pilani. She then completed her MS and PhD in Vision Science from the Ohio State University, USA. Later, she worked as a postdoctoral fellow in the field of vision rehabilitation at Schepens Eye Research Institute, Harvard Medical School, USA.

Dr Satgunam’s clinical interest is in Binocular Vision, Vision Therapy and Orthoptics. Currently, her research work focuses on measuring visual functions (e.g. visual fields) and functional vision testing (e.g. visual search). At present, there are tests and tools available for normal adults whereas fewer tests and tools exist for patients with special needs. Her research work aims at addressing this gap and also gathers scientific evidence in clinical practice.

Dr Shrikant R. Bharadwaj

Dr. Premnandhini Satgunam

Courses Details

Course Duration

30 Days

Continuing Education Credits

02 hours

Course Price

$30

Course Description

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.

Bio

Dr Shrikant R. Bharadwaj

Shrikant Bharadwaj completed his undergraduate degree in Optometry from the Elite School of Optometry, Chennai and a PhD in Vision Science from the University of California Berkeley School of Optometry, USA. After completing his post-doctoral training in Vision Science at the Indiana University School of Optometry, USA, Dr Bharadwaj returned to the L V Prasad Eye Institute (LVPEI) in Hyderabad as a DBT Ramalingaswami Fellow in 2009. He then established the Visual Optics research laboratory at LVPEI with the overall agenda of understanding how the optics of the eye influences spatial vision and depth vision. Dr Bharadwaj uses a combination of experimental, behavioural and computational techniques to address this research agenda. His laboratory actively publishes research work in international peer-reviewed vision science journals and the research work is generously supported by extramural grants from the Government of India and the optical industry. Dr Bharadwaj also serves on the editorial board of Nature Scientific Reports, Optometry and Vision Science, PLoS One and the Indian Journal of Ophthalmology. He also serves as a peer-reviewer for almost all optometry and vision science journals. In addition to his research work, Dr Bharadwaj serves as the Network Associate Director of the Brien Holden Institute of Optometry and Vision Sciences at LVPEI. He is also actively involved in teaching undergraduate and postgraduate students of optometry at the L V Prasad Eye Institute.

 

Dr. Premnandhini Satgunam

Premnandhini Satgunam received her bachelor’s degree in optometry from the Elite School of Optometry, Sankara Nethralaya BITS, Pilani. She then completed her MS and PhD in Vision Science from the Ohio State University, USA. Later, she worked as a postdoctoral fellow in the field of vision rehabilitation at Schepens Eye Research Institute, Harvard Medical School, USA.

Dr Satgunam’s clinical interest is in Binocular Vision, Vision Therapy and Orthoptics. Currently, her research work focuses on measuring visual functions (e.g. visual fields) and functional vision testing (e.g. visual search). At present, there are tests and tools available for normal adults whereas fewer tests and tools exist for patients with special needs. Her research work aims at addressing this gap and also gathers scientific evidence in clinical practice.

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Spasm of Near Reflex: Clinical presentation, near-triad behavior and vision loss with Drs. Shrikant Bharadwaj and Premnandhini Satgunam
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