Accomodative spasm- varied presentation and treatment

Aim: The aim of our study was to analyse the varied presentation and difficulties encountered while treating the patients with accomodative spasm. Methods: A retrospective study of four patients of accomodative spasm. Three were children and one adult. All underwent a thorough work-up to be diagnosed with accommodation spasm and then treated with vision therapy. Results: Average age of the patients was 14.25 years. All the patients underwent in-office vision therapy for the average of 16 sessions followed by maintenance therapy. The average follow-up period was 9 months (range – 6-9 months). One patient didn’t showed improvement after 12 sessions as expected, so sent for systemic evaluation. She was diagnosed with hypothyroidism and treated for the same and continued with vision therapy. One patient presented with acute acquired comitant esotropia (AACE) with pseudomyopia. With the treatment of accomodative spasm, the esotropia and the pseudomyopia resolved. Conclusion: We have discussed about the varied presentation of accomodative spasm and the promising results with vision therapy. Accomodative spasm needs to be looked in children presenting with AACE.