Bilateral blurred distance vision, fluctuating vision, blurred vision when shifting gaze from near to far, headache, and eye strain while reading. Often seen in teenagers under stress. Symptoms may occur after prolonged and intense periods of near work.
Critical
Cycloplegic refraction reveals substantially less myopia (or more hyperopia) than was originally found when the refraction was performed without cycloplegia (manifest refraction). Manifest myopia may be as high as 10 diopters. Spasm of the near reflex is associated with excess accommodation, excess convergence, and miosis and is in the differential diagnosis of sixth cranial nerve palsy (see 10.8 ISOLATED SIXTH CRANIAL NERVE PALSY).
Other
Abnormally close near point of focus, miosis, and a normal amplitude of accommodation that may appear low.