Is pseudomyopia associated with anxiety and related disorders?

Abstract

Objective: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders.
 Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined.
 Results: The average age of patients in the study was 15,4 ± 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D ± 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D ± 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D ± 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount.
 Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase.
 doi: https://doi.org/10.12669/pjms.37.5.3991
 How to cite this:Kara H, Yasar E, Gurlevik U. Is pseudomyopia associated with anxiety and related disorders? Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3991
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Pseudomyopia and Its Association With Anxiety

“…Of them, five had generalized anxiety disorder, three had obsessive-compulsive disorder, three had panic disorders, one had social anxiety disorder, one had posttraumatic disorder, one had conversion disorder, and one had major depressive disorder. Interestingly, positive correlation (p = 0,010; r = 0,621 and p = 0,029; r = 0,546) was observed between anxietysomatization scores and accommodation amount of eye (Figure 2) [23].…”

“…The figure shows that the mean diopter measurement correlates with the mean anxiety score in the symptom checklist-90-R test. As the anxiety score increases, the measured myopia severity increases [23]. In another study done on movement disorders, convergence spasm was present in most of the psychogenic movement disorders cases (69%), with less likely occurrence on nonpsychogenic movement disorders cases and on controls.…”

“…Shetty et al suggested that pseudomyopia was more often seen in women, and it is well known that anxiety disorders are more common in women than men [12,24]. In their study, Kara et al strongly advised that psychiatric consultations should be a part of the multidisciplinary evaluation of every case of pseudomyopia [23].…”

Pseudomyopia: A Review

“…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.…”

“…It is important to discard organic processes, so some authors [ 12 , 16 , 19 , 35 ] recommend a neurological assessment with neuroimaging tests. In addition, the history for psychological triggers or stressors is important to consider [ 34 ] to investigate a possible neurotic/hysterical disposition [ 26 , 41 , 42 ].…”