Accommodative Spasm From Constant Focus

An accommodative spasm is a condition that causes the eye muscle to accommodate or focus constantly and automatically. For example, a person may be concentrating on a close task, such as reading. When they look up, their vision is blurry. Their eye is still focusing on a close-up or near task, even though they are now looking at a distance. Thus, a person with an accommodative spasm has a difficult time relaxing the focusing muscle when looking at a distance.

Intense students learning in a lecture hall
Cultura RM Exclusive / Frank and Helena


Symptoms commonly associated with accommodative spasm include:

  • Blurred vision
  • Fluctuating vision
  • Headache
  • Eye fatigue
  • Loss of concentration during a task

Most of us, at one time or another, have experienced an accommodative spasm. Most experience in high school or college sitting in large lecture rooms. It seems to occur to a lot of students while taking tests. You might be concentrating on your test, filling in those little ovals with a number two pencil. Then, the teacher writes a correction on the board. Then, you look up and you can't seem to focus on the board. It takes several minutes for your vision to clear. You look back at your test and then back to the board and you just can not seem to adjust properly.

Accommodative spasm also seems to occur to a lot of doctors, medical technicians or biologists looking through instruments and microscopes. Most of these instruments have oculars similar to a pair of binoculars. When we look through them, our focusing systems seems to go crazy and vision will fluctuate and it causes our eyes to fatigue quickly. The term used to describe this is instrument myopia.

When accommodative spasm becomes a constant problem and creates symptoms daily, doctors may refer to it as accommodative dysfunction. While the name accommodative dysfunction encompasses many focusing disorders, it often refers to younger individuals or children that have not only accommodative spasm but also have a very difficult time focusing on near objects altogether.

The condition creates symptoms similar to presbyopia. Presbyopia is the condition that occurs over 40 years of age where we begin to lose our focusing ability on near objects. Accommodative dysfunction occurs in individuals much younger and most often, young children.


Because general accommodative spasm is most often temporary, no treatment is needed. When people suffer from symptoms more often, vision therapy is prescribed. Vision therapy may be simple eye exercises or eye exercises combined with special lenses. Biofeedback therapy or relaxation techniques have also been recommended. Taking a vacation after a stressful event will alleviate the accommodative spasm as well.

For students, doctors may prescribe a bifocal or progressive lens. These lenses allow for your distance prescription (or no power if you do not need glasses for distance) to be made in the top half of the lens and a reading power in the lower half of the lens. No-line, graduated progressive lenses often work very for this problem. Other vision correction options.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Rutstein RP. Accommodative spasm in siblings: a unique findingIndian J Ophthalmol. 2010;58(4):326–327. doi:10.4103/0301-4738.64123

  2. Lindberg L. [Spasm of accommodation]. Duodecim. 2014;130(2):168-73.

  3. Gedar totuk OM, Aykan U. A new treatment option for the resistant spasm of accommodation: clear lens extraction and multifocal intraocular lens implantation. Int J Ophthalmol. 2018;11(1):172-174. doi:10.18240/ijo.2018.01.28

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.