목적 : 다양한 정도의 근접반사 연축을 보였던 환자 5명의 가성근시 및 눈모음 양의 변화를 통한 예후를 보고자 하였다. 대상과 방법 : 근접반사 연축을 보였던 환자 5명의 초진시와 추적 관찰시 나안 및 최대교정시력, 현성 및 조절마비굴절검사를 통한 가성근시의 정도, 동공의 크기, 교대프리즘가림검사를 이용한 눈모음의 양, 안구운동 제한여부, 세극등현미경 및 안저검사를 시행하였다. 결과 : 다양한 정도의 근접반사 연축을 보였던 5명의 환자 중 조절연축만을 보였던 경우는 3명이었고, 조절연축에 눈모음과 축동까지 동반한 환자는 2명이었다. 환자들의 가성근시 및 눈모음의 양은 평균 –8.0D, 14PD였고 평균 10.8개월만에 없어졌으나, 조절연축의 환자 중 1명에서 재발하였고, 근접반사 연축의 경우 1명에서는 눈모음 정도는 좋아졌으나 조절연축은 더 심해졌고, 다른 1명에서는 재발하였다. 결론 : 근접반사 연축 환자 중 가장 많은 임상적 양상은 조절연축의 형태이며, 이 경우가 눈모음연축과 축동이 같이 동반 될 때보다 경과나 재발의 관점에서 예후가 더 좋음을 알 수 있었다.

Purpose: To determine changes in the degree of pseudomyopia and convergence in patients with spasm of the near reflex. Methods: In 5 patients with spasm of the near reflex, we checked following: UCVA/BCVA, the degree of pseudomyopia revealed through manifest and cycloplegic refraction tests, pupil size, limitation of EOM, the amount of convergence defined by the alternate prism cover test, and slit lamp and funduscopic exams. Results: Of the 5 patients with spasm of near reflex, 3 had accommodative spasm alone and 2 had accommodative spasm, convergence spasm and miosis. The patients' degrees of pseudomyopia and convergence were -8.0D and 14PD on the average. which disappeared after an average of 10.8 months but recurred in 1 of the 3 patients with accommodative spasm. As for spasm of the near reflex, 1 patient showed improvement in convergence but worsening pseudomyopia during the follow-up period, and another patient showed recurrence. Conclusions: The most common clinical feature of spasm of the near reflex is accommodative spasm. Patients with accommodative spasm alone showed better prognosis among all patients with spasm of the near reflex in terms of recurrence and the disease course.

Purpose: To determine changes in the degree of pseudomyopia and convergence in patients with spasm of the near reflex. Methods: In 5 patients with spasm of the near reflex, we checked following: UCVA/BCVA, the degree of pseudomyopia revealed through manifest and cycloplegic refraction tests, pupil size, limitation of EOM, the amount of convergence defined by the alternate prism cover test, and slit lamp and funduscopic exams. Results: Of the 5 patients with spasm of near reflex, 3 had accommodative spasm alone and 2 had accommodative spasm, convergence spasm and miosis. The patients' degrees of pseudomyopia and convergence were -8.0D and 14PD on the average. which disappeared after an average of 10.8 months but recurred in 1 of the 3 patients with accommodative spasm. As for spasm of the near reflex, 1 patient showed improvement in convergence but worsening pseudomyopia during the follow-up period, and another patient showed recurrence. Conclusions: The most common clinical feature of spasm of the near reflex is accommodative spasm. Patients with accommodative spasm alone showed better prognosis among all patients with spasm of the near reflex in terms of recurrence and the disease course.

Accommodative spasm, Convergence spasm, Pseudomyopia, Spasm of the near reflex