Myopia progresiva after head injury

Abstract

Introduction:
Accommodation spasm refers to a condition in which there is a constant contraction of the ciliary muscles for excessive parasympathetic stimulation. This phenomenon can result in pseudomyopization, along with convergent strabismus or miosis. It is described in the literature in connection with closed head trauma – head injury, brain injury or direct eye injury. In the majority of patients the condition disappeared itself within a few months, but in rare severe cases the condition has become permanent.

Case report:
In the presentation, we would like to present a case of a young 27-year-old man who has come to impaired distance vision after a car accident in 2016. His natural distance visual acuity was 0.1 in the right eye and 0.06 in the left eye. The best corrected visual acuity of the right eye with correction progressed from (SE) -1,75 dpt to -6.0 dpt and of the left eye from -1,25 dpt to -4,75 in the observed period of 5 years after the injury.
The work summarizes the results of established therapy with 0,01%-0,02% Atropine over a period of 3,5 years.

Conclusion:
It is important to think about these rare causes of refraction changes, because an early intervention can significantly affect the accommodation spasm not only on the myopic refraction caused by spasm, but also on the patient's psychology causing possible permanent injury consequences.