GeneHealth - Your precision medicine

Accommodative Spasm

Disease Details

Family Health Simplified

Buy Membership

Description: Accommodative spasm is a condition where there is an involuntary and sustained contraction of the ciliary muscle, leading to difficulty in maintaining focus on distant objects.
Type: Accommodative spasm is primarily a functional vision disorder rather than a genetic disease, and it doesn't follow a specific type of genetic transmission. It is characterized by excessive contraction of the ciliary muscle, leading to difficulties in focusing on objects. Its occurrence is often linked to prolonged near-work or visual stress rather than hereditary factors.
Signs And Symptoms: **Signs and Symptoms of Accommodative Spasm:**

1. **Blurred Vision**: Difficulty in maintaining clear vision, especially with near tasks.
2. **Eye Strain**: Discomfort and tiredness in the eyes after reading or close work.
3. **Headaches**: Often occurring after prolonged visual tasks.
4. **Double Vision (Diplopia)**: Seeing two images of a single object.
5. **Difficulty Shifting Focus**: Trouble transitioning from near to far objects and vice versa.
6. **Photophobia**: Sensitivity to light.
7. **Eye Pain**: Discomfort or pain in and around the eyes.
8. **Reduced Visual Acuity**: Decreased sharpness of vision.

These symptoms often exacerbate during tasks that require intense near vision, such as reading or screen use.
Prognosis: For routine cases of spasm of accommodation, the American Optometric Association says the prognosis is fair and on average, the number of visits a patient needs will be 1-2 for evaluation and 10 follow up visits. Additionally, the AOA recommends the following management plan for spasm of accommodation: "Begin with plus lenses and VT; if VT fails, use cycloplegic agent temporarily; educate patient".For more chronic and acute cases that do not respond to vision training and cycloplegic drops, the eye muscles should weaken with advancing age providing intermittent or permanent relief from this condition.
Onset: Accommodative spasm, also known as ciliary spasm or spasm of accommodation, typically has an acute or subacute onset. It can occur suddenly and is often triggered by prolonged near work, such as reading or using a computer. The condition may come on in episodes and can affect individuals of any age, though it is more common in young people and those who engage in extensive close-up visual tasks.
Prevalence: There is limited comprehensive data on the precise prevalence of accommodative spasm. However, it is relatively rare compared to other accommodative disorders, often seen more frequently in younger individuals, particularly those who engage in extensive near-vision tasks such as reading or using digital devices.
Epidemiology: There is limited specific epidemiological data available for accommodative spasm, also known as spasm of the near reflex. This condition tends to be relatively uncommon and is often underdiagnosed. It can affect individuals of any age but is more frequently observed in young adults and adolescents, often coinciding with periods of high visual demand, such as extensive near work or studying. In general, accommodative disorders, including spasm, may be more prevalent in populations with significant near-vision tasks or stress.
Intractability: Accommodative spasm, also known as ciliary spasm, is generally not considered intractable. While it can be challenging to manage, particularly in severe or persistent cases, various treatments such as vision therapy, corrective lenses, and medications can be effective in alleviating symptoms. The prognosis often depends on the underlying cause and the individual's response to treatment.
Disease Severity: Severity of accommodative spasm can vary based on the individual and the extent of the spasm. It can be mild, causing occasional discomfort and temporary vision issues, or severe, leading to chronic eye strain, headaches, and persistent blurry vision.
Healthcare Professionals: Disease Ontology ID - DOID:11637
Pathophysiology: Accommodative spasm is a condition where there is an involuntary and sustained contraction of the ciliary muscle, leading to an excessive focusing effort of the eye. This results in symptoms such as blurred vision, headaches, and eye strain. The pathophysiology involves an overactive accommodative response, which can be triggered by prolonged near work, emotional stress, or certain medications. This excessive contraction prevents the normal relaxation of the ciliary muscle, disrupting the eye's ability to shift focus from near to distant objects effectively. The exact neural mechanisms underlying this excessive contraction are not fully understood, but it is often managed with vision therapy, appropriate use of reading glasses, or addressing any underlying stressors.
Carrier Status: Accommodative spasm, also known as ciliary spasm or pseudomyopia, does not have a carrier status because it is not a genetic disorder. It is a condition where there is an involuntary, excessive contraction of the ciliary muscle, which affects the eye's ability to focus properly.
Mechanism: Accommodative spasm, also known as ciliary spasm, is a condition where the ciliary muscle in the eye remains in a persistent state of contraction, leading to difficulties in focusing.

**Mechanism:**
- **Ciliary Muscle Hyperactivity:** The ciliary muscle responsible for focusing the lens in the eye becomes overactive and does not relax as it should. This overactivity can cause prolonged contraction resulting in sustained near vision and blurred distance vision.
- **Sympathetic and Parasympathetic Imbalance:** The condition is often associated with an imbalance between the parasympathetic and sympathetic nervous systems. The parasympathetic nervous system promotes ciliary muscle contraction via the release of acetylcholine, while the sympathetic nervous system typically relaxes it through the release of norepinephrine.

**Molecular Mechanisms:**
- **Acetylcholine:** The neurotransmitter acetylcholine plays a key role in ciliary muscle contraction. Overstimulation or excessive release of acetylcholine can lead to sustained contraction of the ciliary muscle.
- **Muscarinic Receptors:** The ciliary muscle contraction is mediated by muscarinic acetylcholine receptors (M receptors), primarily M3 receptors. Overactivation of these receptors can lead to excessive contraction.
- **Calcium Signaling:** The activation of M3 receptors increases intracellular calcium levels, which is essential for muscle contraction. Any dysregulation in calcium signaling pathways can contribute to the sustained contraction seen in accommodative spasm.

In summary, accommodative spasm involves overactivity of the ciliary muscle due to parasympathetic stimulation, with acetylcholine playing a major role in the process via M3 receptor activation and calcium signaling pathways.
Treatment: For accommodative spasm, treatment typically includes:

1. **Optical Correction**: Accurate prescription of glasses or contact lenses, sometimes including bifocals or progressive lenses.

2. **Vision Therapy**: Exercises to improve eye coordination and focusing ability.

3. **Pharmaceuticals**: Cycloplegic eye drops to temporarily paralyze the ciliary muscle and alleviate spasms.

4. **Lifestyle Modifications**: Taking regular breaks during prolonged near tasks, proper lighting, and ergonomic adjustments.

Consultation with an optometrist or ophthalmologist is recommended for a tailored approach.
Compassionate Use Treatment: Accommodative spasm, also known as accommodative excess, involves involuntary, excessive contraction of the ciliary muscle leading to difficulty in focusing on distant objects. Treatment options beyond standard care are limited but may include off-label or experimental treatments such as:

1. **Cycloplegic Eye Drops**: Medications like atropine or cyclopentolate can be used off-label to temporarily paralyze the ciliary muscle, providing relief from spasms.

2. **Beta-blockers**: Occasionally, beta-blocker eye drops like Timolol are used off-label to reduce accommodative stress.

3. **Vision Therapy**: This includes specialized exercises to improve control over the focusing mechanism, and though not widely recognized as standard treatment, it can be beneficial.

4. **Botulinum Toxin Injections**: In rare and severe cases, botulinum toxin (Botox) injections into the ciliary muscle have been experimentally attempted to reduce muscle contractions.

All these treatments should be considered and monitored by an ophthalmologist or healthcare provider experienced in managing accommodative spasm.
Lifestyle Recommendations: For accommodative spasm, lifestyle recommendations include:

1. **Regular Breaks**: Take frequent breaks during activities that require prolonged near vision, like reading or computer work, to reduce eye strain.
2. **Proper Lighting**: Ensure adequate lighting when performing tasks that need near vision to avoid excessive eye strain.
3. **Eye Exercises**: Engage in eye exercises prescribed by an eye care professional to help improve eye focusing and flexibility.
4. **Balanced Diet**: Maintain a diet rich in vitamins and minerals that support eye health, such as Vitamin A, C, E, and zinc.
5. **Hydration**: Keep well-hydrated to maintain overall eye health.
6. **Ergonomics**: Ensure your workstation is ergonomically set up to minimize strain on your eyes and body.
7. **Regular Eye Exams**: Schedule regular eye check-ups to monitor and manage the condition effectively.
8. **Reduce Screen Time**: Limit time spent on digital devices or use blue light filters to decrease eye strain.

Implementing these measures can help manage symptoms and promote overall ocular health.
Medication: There is no specific medication designed exclusively to treat accommodative spasm. However, management may include the use of cycloplegic agents such as atropine or homatropine, which temporarily paralyze the ciliary muscle, thereby reducing the spasm. It's essential to consult an eye care professional for an accurate diagnosis and appropriate treatment plan.
Repurposable Drugs: For accommodative spasm, there are currently no well-established repurposable drugs specifically approved for this condition. Management typically involves non-pharmacological approaches such as vision therapy, and, in some cases, may involve the use of cycloplegic agents to temporarily paralyze the ciliary muscle to provide relief. Consultation with an eye care professional is essential for a tailored treatment plan.
Metabolites: Accommodative spasm is a condition involving the involuntary contraction of the ciliary muscle, leading to prolonged accommodation of the eye. There are no specific metabolites directly linked to accommodative spasm because it is primarily a functional vision disorder rather than a biochemical or metabolic disease. However, general metabolic health and stress levels could potentially influence the severity or frequency of symptoms.
Nutraceuticals: There is no well-established evidence that nutraceuticals can effectively manage or treat accommodative spasm. This condition primarily involves excessive and involuntary contraction of the eye's ciliary muscle, leading to difficulty with focusing. Management typically includes vision therapy, corrective lenses, and addressing any underlying factors such as stress or excessive near work. If you have specific concerns, consulting an eye care professional is recommended.
Peptides: Accommodative spasm, also known as ciliary spasm, involves a condition where the ciliary muscle in the eye remains in a state of constant contraction, causing sustained focusing on close objects and difficulty shifting focus to distant objects. As of now, there isn't a direct link between peptides or nanotechnology (nan.) treatments specifically tailored for accommodative spasm. Current management primarily involves techniques such as vision therapy, atropine drops, and corrective lenses to help alleviate symptoms.