spasms of accommodation

I have spasms of accommodation.  When I look at something I go back and forth trying to find the right distance.  There is no best distance.  They say my eyes don't focus.  Doctors do not know what to do.  Where is a doctor that works with this and knows what to do?



This discussion is related to Should I increase my glasses to fix Spasm of accommodation?.

[John C Hagan III, MD, FACS, FAAO]

You best choice would be a MD ophthalmologist specializing in neuro-ophthalmology. Find one at www.aao.org

JCH MD

[John C Hagan III, MD, FACS, FAAO]

The cost of seeing a neuro-ophthalmologist will likely be far less than the expensive optometric vision therapy that seems to go on forever till the insurance is exhaused or the patient runs out of money or patience.

JCH MD

[venjer]

go to a doctor who can examine your vision acuity with 2% Cyclogyl (a brand by alcon, cyclonpentolate is the generic name) and that has an Auto-Refractor Machine also known as Objective Refraction.

(1) have them examine your eyes with Auto-Refraction (machine -this take 15 seconds) when you arrive before the cycloplegia effect

don't forget to take the print of your RX from the machine

(2) instill one drop of 2% Cyclogyl in each eye, and maintain your eyes shut until the next instillation

(3) maintain your eyes shut for 10 minutes (set an alarm clock)

(4) instill 2% Cyclogyl

(5) maintain your eyes shut for 10 minutes (set an alarm clock)

(6) instill 2% Cyclogyl for the third time

(7) maintain your eyes shut for 40 minutes (set an alarm clock), 30 minutes could also work but wait 40 min if possible

(8) have them  examine your eyes with Auto-Refractor machine (it take 15 seconds)

don't forget to take the print of your RX from the machine

and you're done !

(9) Ask to measure your dual PD , they should give you 2 PDs number, one for each eye. That mean, you ask them to measure the PD for each eye separately. PD for each eye should be in the range of 24-35
* if they give u a single PD in the range of 50-70 ask for dual aka 2 PDs

**(10) cycloplegia subjective refraction-IS NOT RELEVANT TO OUR GOAL. they would probably insist you perform subjective refraction as well - this is when doctor switch different lens power and ask you how well you can see

ask them to write the prescription result right after the examination is done

(11) USE THE CYCLOPLEGIA AUTO REFRACTION PRESCRIPTION FOR YOUR NEW GLASSES /LENSES
->you can also transition gradually toward the cyclo (cylcoplegia)autorefraction RX (prescription) with partial correction, until you can adjust to the full cyclo RX

*the most important variable is the vision balance between the two eyes, or as I refer to as Gap between the eyes ( GAP= Left - Right ) which determined load effort balance.


(12) take a month to adjust to new prescription, then start training your eyes with HTS vision therapy computer software or Ablyopia dedicated software by HTS or other vendors.

**From our point of view, the problem with subjective refraction is that the aim of this evaluation is to neutralize the focus muscles strain by applying cycloplegia which relax these muscles. The more you use your eyes, and the more effort impose on the focus muscles, the more it set off and reduce the cycloplegia effect.  What happen is that the relatively long process of the subjective refraction, combined with the effort imposed on your "relaxed" ciliary muscles reduce the cycloplegia effect, and therefore distort the refraction result.

Many doctors do not fully understand this point and its importance, in particular with patients with muscles problems like you, me and others. Know this, almost any eye problems also cause muscles problems cause the balance of vision, effort load balance, cause a secondary effect in the form of fusion /vergence problem. with that being said, while vision therapy is the gold standard for muscles problem, the initial cause of the eyes problems must be resolved beforehand, in order for the vision therapy to prove successful

[Luvtoski]

Wow, you are good venjer !  Thanks for helping all of us.