Ocular hypertonia and the accommodative effort: which relation?

Author: 
Said Iferkhass., Nihad Elhalouat and Abdelkader Laktaoui

Introduction: Our work consists in studying the ocular tension and its evolution before and after relaxation of the accommodation by a full optical correction (FOC).
Materials and methods: we have a prospective study from January 2014 to December 2016; out of 60 patients including 36 (60%) followed somewhere else for open-angle glaucoma (based on visual field alteration without structural damage) and 24 (40%) isolate ocular hypertonia, followed in ophthalmology department Military Hospital Moulay Ismail in Meknes.
The following data were analyzed: age of patients, antecedents, average value of three ocular tones taken by applanation tonometer before and after three and six months of initial full optical correction port.
Results: The average age is 45 years [7-60 years] with sex ratio H / F: 1. 66.5% of our patients had symptomatic farsightedness and 88.2% of cases an accommodative spasm. Comparing the refraction of spherical equivalent before and after cycloplegic on the 120 eyes of our cases, shows an average difference of 1 diopter. The ocular tone decreased by a mean of 6.24mmHg in the right eye (OD) and 6.52mmHg in the left eye (OS), after three months of FOC. And after six months it decreased: 7.74mmHg OD and 7.82 mmHg OG. The difference was statistically significant (p = 10 -3). Conclusion: Based on our study data, relaxation of accommodation by FOC, particularly in symptomatic hypermetropic patients or those with accommodative spasm, improves ocular tone and functional signs. This leaves us to evoke the hypothesis of an "accommodative hypertonia".
This study paves the way for other prospective and multicenter studies to confirm or annihilate it.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2018. 16166.2970
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