SPASM OF THE NEAR REFLEX - A SPECTRUM OF ANOMALIES

Spasm of the near reflex has been characterized as the variable appear ance of pseudomyopia, convergent strabismus and miosis. These characte ristics may appear together or separately. In addition, abnormalities of accommodation may appear not only as pseudomyopia, but may also be manifest in cases with significant hypermetropia in which the patient is unable to relax accomodation even when plus lenses are used. The in tent of this review is to identify the various clinical presentations of anomalies of the entire near reflex as well as the component parts. The relationship to functional and organic disorders are discussed as well as the related neuroanatomy. We suggest that one may more readil y understand the clinical manifestations as a spectrum of anomalies of the near reflex rather than a multitude of disconnected entities.