ATYPICAL COURSE OF ACCOMMODATIVE ASTHENOPIA. CLINICAL CASE
Keywords:asthenopia, accommodation, headache, interdisciplinary approach
Asthenopia – visual discomfort that develops during visual load. Complaints usually lay outside traditional ophthalmology and require a qualifi ed review of doctors in related specialties. Among the symptoms of asthenopia, headache often occurs. This requires careful differential diagnosis, as it can be a manifestation of not only ophthalmic diseases, but also neurological disorders. A clinical case of accommodative asthenopia with headache is presented.
The patient 25 years old, visited the neurosurgeon, with complaints of headaches and pain outside the eyes, in the frontal area, with strengthening – also in the occipital area. Pain appear only when looking at small parts at close range (“disassembling the clock”, “reading from a smart phone”). When reading a book, work on a computer such complaints usually does not arise.
In neurological status, changes were not detected. Additional instrumental studies (MRT of the cervical area and brain, ultrasound examination of the vessels of the head and neck) have been performed. Pathological changes were not detected. Established diagnosis: hypermetropic astigmatism of the weak degree of the right eye. Accommodative asthenopia syndrome. Headache associated with refraction violation (11.3.2 – according to the International Classifi - cation of Headache Disorder III B). The patient was recommended optical correction for the near, relaxing eye exercises, the course of instillations of irifrine for 1 month, hardware treatment. After 1 month, the patient reported on the phone about signifi cant improvement. In provision of medical care to such patients interdisciplinary approach should prevail with involving specialists in related fi elds.
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