Summary about Disease
Pseudomyopia, also known as accommodative spasm or near-work-induced transient myopia, is a condition where the eye muscles responsible for focusing (ciliary muscles) spasm, causing temporary blurred distance vision similar to nearsightedness (myopia). It's not true myopia because there's no structural change in the eye; the focusing system is simply temporarily overactive. It's often associated with prolonged near work, stress, or certain medications.
Symptoms
Blurred distance vision (the primary symptom)
Eye strain
Headaches
Difficulty focusing when switching between near and far objects
Eye fatigue
Feeling of eye discomfort or heaviness
In some cases, double vision (diplopia)
Causes
Prolonged Near Work: Excessive reading, computer use, or other activities that require sustained close focusing.
Stress and Anxiety: Psychological stress can trigger muscle tension, including in the ciliary muscles.
Fatigue: General tiredness can exacerbate accommodative spasm.
Medications: Certain drugs (e.g., cholinergics) can induce ciliary muscle contraction.
Uncorrected Refractive Error: Existing farsightedness (hyperopia) or astigmatism can contribute.
Accommodative Dysfunction: Underlying problems with the eye's focusing system.
Medicine Used
Cycloplegic Eye Drops: These drops (e.g., cyclopentolate, tropicamide) temporarily paralyze the ciliary muscle, relieving the spasm and allowing the eye to relax. They are often used for diagnosis and short-term treatment.
Low-dose atropine: In some cases, very low concentrations of atropine eye drops may be used for longer-term management, especially in children.
Artificial Tears: Help to lubricate the eyes and reduce eye strain.
Prism lenses: Occasionally, prism lenses may be prescribed to relieve eye strain associated with convergence insufficiency (difficulty turning the eyes inward).
Is Communicable
No, pseudomyopia is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Take Frequent Breaks: When doing near work, follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.
Maintain Proper Posture: Ensure good ergonomics when working at a desk or computer.
Adequate Lighting: Use sufficient and appropriate lighting to reduce eye strain.
Manage Stress: Practice relaxation techniques to reduce stress and anxiety.
Correct Refractive Errors: Ensure any underlying refractive errors (e.g., hyperopia, astigmatism) are corrected with glasses or contact lenses.
Limit Screen Time: Especially for children, limit excessive screen time and encourage outdoor activities.
Regular Eye Exams: Schedule regular eye exams to monitor eye health and detect any underlying vision problems.
How long does an outbreak last?
The duration of pseudomyopia varies. It can be transient, lasting for a few minutes or hours after prolonged near work. In other cases, it can persist for days or weeks, especially if the underlying causes are not addressed. The use of cycloplegic eye drops usually provides temporary relief, but the symptoms may return if the precipitating factors (e.g., excessive near work) continue.
How is it diagnosed?
Comprehensive Eye Exam: A thorough eye exam by an optometrist or ophthalmologist is crucial.
Refraction: Measuring the refractive error of the eye (myopia, hyperopia, astigmatism). This is done with and without cycloplegic drops. The difference in refraction with and without cycloplegia helps determine the amount of accommodative spasm.
Accommodation Testing: Assessing the eye's ability to focus at different distances.
Slit-Lamp Examination: Examining the structures of the eye to rule out other potential causes of blurred vision.
Patient History: Gathering information about symptoms, near-work habits, stress levels, and medications.
Timeline of Symptoms
The timeline of symptoms can vary significantly.
Initial Stage: Gradual onset of blurred distance vision, often after prolonged near work.
Progression: Symptoms may worsen with continued near work or stress. Headaches and eye strain may develop.
Peak: Symptoms are most noticeable, with significant blurred distance vision and potential difficulty focusing.
Resolution (with treatment or rest): Blurred vision gradually improves, and eye strain diminishes. Symptoms may recur if near-work habits are not modified.
Important Considerations
Differential Diagnosis: It's important to rule out other causes of blurred vision, such as true myopia, cataracts, or other eye diseases.
Binocular Vision Assessment: Evaluate binocular vision function, including convergence and eye teaming abilities.
Underlying Conditions: Consider whether underlying medical conditions (e.g., anxiety, depression) may be contributing to the problem.
Treatment Adherence: Patient compliance with recommended treatments and lifestyle modifications is essential for successful management.
Vision Therapy: In some cases, vision therapy exercises may be recommended to improve accommodative and binocular vision skills.
Monitor Progress: Regular follow-up eye exams are necessary to monitor progress and adjust treatment as needed.