Combined Interventions for Nonorganic Visual Loss in a Case with Pseudo-Myopia: A Perspective from Vietnam

Nguyen, Hoang-Nam; Hoang, Tung Thanh; Tran, Anh Phuong; Tran, Huy

doi:10.1159/000508236

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…There are other causes that generate pseudomyopia: emotional/psychological disorders [ 9 , 34 , 40 , 41 , 42 , 43 ], acquired brain injuries [ 18 , 25 , 36 , 40 , 44 , 45 ] and ocular traumas [ 22 ]. After brain injury, several structures associated with the control of accommodation can be injured.…”

Section: Resultsmentioning

confidence: 99%

Pseudomyopia: A Review

García-Montero

Felipe-Marquez

Arriola‐Villalobos

et al. 2022

Vision

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This review has identified evidence about pseudomyopia as the result of an increase in ocular refractive power due to an overstimulation of the eye’s accommodative mechanism. It cannot be confused with the term “secondary myopia”, which includes transient myopic shifts caused by lenticular refractive index changes and myopia associated with systemic syndromes. The aim was to synthesize the literature on qualitative evidence about pseudomyopia in terms that clarify its pathophysiology, clinical presentation, assessment and diagnosis and treatment. A comprehensive literature search of PubMed and the Scopus database was carried out for articles published up to November 2021, without a data limit. This review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Following inclusion and exclusion criteria, a total of 54 studies were included in the qualitative synthesis. The terms pseudomyopia and accommodation spasm have been found in most of the studies reviewed. The review has warned that although there is agreement on the assessment and diagnosis of the condition, there is no consensus on its management, and the literature describes a range of treatment.

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Section: Resultsmentioning

confidence: 99%

Pseudomyopia: A Review

García-Montero

Felipe-Marquez

Arriola‐Villalobos

et al. 2022

Vision

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“…Consequently, considering a functional diagnosis, she was referred to a pediatric psychiatrist who diagnosed her with conversion disorder. She was diagnosed with functional visual loss associated with spasm of accommodation and was treated with psychotherapy and cycloplegic drugs [ 19 ]. From the above discussion, it is clear that psychological causes affect the autonomic nervous system.…”

Section: Reviewmentioning

confidence: 99%

Pseudomyopia and Its Association With Anxiety

Khalid¹,

Padda²,

Pokhriyal³

et al. 2021

Cureus

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Pseudomyopia is an inappropriately excessive accommodation of the eye due to overstimulation or ciliary spasm, which leads to a marked approximation of the far point. Common symptoms of pseudomyopia include eye strain or fatigue, and it is classified as organic or functional. The latter is due to eye strain and functional increase in the ciliary tonus. Pseudomyopia can vary from being a transient condition or continue to progress to myopia. Head trauma is the most common cause followed by psychiatric illnesses, neurologic diseases, and drug-induced causes. There is an association between psychological stress-inducing events and pseudomyopia as it affects the autonomic nervous system. The human body counteracts anxiety by activating the parasympathetic nervous system, causing ciliary muscle contraction. Underlying psychiatric diseases in pseudomyopia patients have been reported in the past in multiple studies. Generalized anxiety disorder is the most common psychiatric illness associated with pseudomyopia with a positive correlation between anxiety-somatization scores and accommodation amount of the eye. It is strongly advised that a psychiatric consultation should be included in the multidisciplinary evaluation of every case. If patients have coexisting anxiety disorders, a multidisciplinary approach using psychiatric consultations, work environment changes, ocular exercises, and cycloplegic drugs can be used. This review aims to shed light on the association of psychiatric disorders such as anxiety with pseudomyopia.

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The etiology, diagnostics, and treatment of the spasm of the near reflex - a narrative review

Szczęśniak,

Sikorska,

Rajca

et al. 2024

European Journal of Ophthalmology

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Physiological adaptation of the eye to the visual perception of near objects consists of the “near triad”: convergence, accommodation, and pupil miosis. Normally, these tend to revert when one stops fixating on a near object. Spasm of the near reflex (SNR) is a pathological phenomenon, which manifests itself by the persistence of the above-mentioned adjustments, which prevents the eye from returning to its relaxed state. In this narrative review, we aim to summarize the etiology, diagnostics, treatment, and prevention of SNR. The literature review was performed by searching online databases. The clinical presentation of SNR is diverse; it presents as isolated accommodative spasm more frequently than impairment of all three components of the near triad. Patients usually present with fluctuations in visual acuity, blurred vision, diplopia, and asthenopia. The etiology is not fully understood. Potential causes include neuroanatomic, organic, and psychogenic disorders. The diagnosis is clinical, based on the constellation of symptoms and assessment of the near triad. The diagnostic golden standard is a cycloplegic examination of refraction, preferably using cyclopentolate hydrochloride (1%, 0.5%, or 0.1% solution). The first-line treatment requires the administration of a cycloplegic drug in combination with plus lenses, flipper lenses, optical fogging, or miotics. For secondary cases, causal treatment should be implemented. Prevention of SNR should be based on eliminating modifiable risk factors. We propose including screening for SNR symptoms in every ophthalmic examination, especially among patients with psychogenic or neural disorders, after brain trauma, or young adults spending much time in front of computer screens.

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Combined Interventions for Nonorganic Visual Loss in a Case with Pseudo-Myopia: A Perspective from Vietnam

Cited by 4 publications

References 10 publications

Pseudomyopia: A Review

Pseudomyopia: A Review

Pseudomyopia and Its Association With Anxiety

The etiology, diagnostics, and treatment of the spasm of the near reflex - a narrative review

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