Pseudomyopia: A Review

Abstract

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.

Evaluasi Klinik Autorefraktor NIDEK TONOREF III Dibandingkan dengan Refraksi Subjektif pada Populasi Miopia Muda

“…Temuan kelainan tersebut merupakan indikasi pemeriksaan kelainan refraksi dengan menggunakan sikloplegik. 30…”

Accommodative spasm and its different treatment approaches: A systematic review

“…27 Variations in visual acuity at a distance, retinoscopic reflex, and pupil size are caused by fluctuations in accommodation. 6 An accommodative spasm may manifest as a spasm of the near reflex or pseudomyopia. 4 Large exophoria, intermittent divergent squint, 19 and the sudden onset of esotropia 22 11,14,32 Rutstein and Totle report that a 27-year-old woman with accommodative spasm has had finger-counting vision in her left eye for the past two months.…”

“…27 A meticulous retinoscopy-based manifest refraction result suggests estimating the lowest negative lens power that results in the highest visual acuity. 6 High minus power in manifest refraction and zero or less plus power in cycloplegic refraction are clinical indicators of accommodative spasm. 27 Cycloplegic refraction is generated by applying 1% atropine eye drops twice per day for three days prior to the refraction, or 1% cyclopentolate and 1% tropicamide eye drops twice with a five-minute interval.…”

“…5 Most of the time, cycloplegic eye drops can correct manifest myopia, a condition known as pseudomyopia. 6 Pseudomyopia exists in two varieties. First, constant accommodative tension during near work elevates ciliary muscle tone, which is common in young hyperopes and presbyopes.…”

“…7 As a result, the refractive error is either less myopic or more hypermetropic. 6 The symptoms of accommodative spasm include variations in visual acuity, inconsistent retinoscopy findings, unpredictable refractive error, lead of accommodation in dynamic retinoscopy, and asthenopic symptoms. 8 The mechanism that causes accommodative spasms is still unknown.…”