A comprehensive management protocol and treatment outcomes o
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A Study was conducted to report a consolidated management protocol for patients with spasm of near reflex (SNR), including classification of cases as mild, moderate, and severe based on treatment outcomes.

Patients with SNR treated were included. Management of SNR included modified optical fogging, vision therapy, and pharmacological intervention (cyclopentolate eye drops and, if required, atropine eye drops). Outcome measures were visual acuity (20/25 or better) and refractive error (reduction of excessive myopia).

Results:
--Of 1,306 patients examined during the study period, 66 were diagnosed with SNR, yielding a prevalence of 5% among first-time patients visiting our binocular vision and orthoptics clinic.

--Of the 45 patients recruited for this study, all three near-triad components were involved in 11 patients, only the accommodation component were in 32, and only the convergence component in 2.

--SNR was relieved in the first post-cyclopentolate refraction visit or with the modified optical fogging technique in 29 patients (66%; mild SNR) and with one-time usage of atropine eyedrops in 10 patients (22%; moderate SNR).

--In 6 patients (13%), atropine was continued long-term (severe SNR). Of 15 patients with long-term follow-up (1 year), 11 (73%) had persistent relief of SNR.

In conclusion, the host SNR with a lodging element was the most popular, with cycloplegic eye drops and optical intervention that could essentially be relaxed once in a while. The use of powerful cycloplegics may only be required by serious cases of SNR.

Source: https://www.jaapos.org/article/S1091-8531(21)00142-7/fulltext?rss=yes
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