PARALYSIS OF ACCOMMODATION

(continue  ACCOMMODATION ANOMALIES)
Paralysis of accommodation also known as
cycloplegia refers to complete absence of accommodation.

Causes
1. Drug induced cycloplegia results due to the effect of atropine, homatropine or other parasympatholytic drugs.

2. Internal ophthalmoplegia (paralysis of ciliary muscle and sphincter pupillae) may result from neuritis associated with diphtheria, syphilis,
diabetes, alcoholism, cerebral or meningeal diseases.
 
3. Paralysis of accommodation as a 
component of complete third nerve paralysis may occur due to intracranial or orbital causes. The lesions may be
traumatic, inflammatory or neoplastic in nature.

Clinical features
1. Blurring of near vision. It is the main complaint in previously emmetropic or hypermetropic patients. Blurring of near vision may not be marked in myopic patients.

2. Photophobia (glare) due to accompanying dilatation of pupil (mydriasis) is usually associated with blurring of near vision.

3. Examination reveals abnormal receding of near point and markedly decreased range of accommodation.

Treatment
1. Self-recovery occurs in drug-induced paralysis and in diphtheric cases (once the systemic disease is treated).
2. Dark-glasses are effective in reducing the glare.
3. Convex lenses for near vision may be prescribed if the paralysis is permanent.