accommodative spasm question (yeah the previous question rang a bell)?

Question

I've always wondered. Suppose they do dilate your pupils and it turns out you do have accommodative spasms. Yet you still CAN´T see even if your nearsightedness is not "real" but due to the spasms. Do you still need to wear glasses? How is this solved?

Answer 1

I DONT KNOW!?!?!?!?????!?!?!/?

Answer 2

I've had that happen a few times:
*prove* that the vision can be good in the distance without glasses, but have the ciliary spasm tend to come back in almost the instant the cycloplegic drops wear off.

Accepting that the ciliary spasm is a "permanent squatter" and giving long-distance glasses for it really is a last resort.
I've had to do it a couple of times, purely for driviing, as a lesser of two evils thing.
But prior to that, I'd train the patient in eye-relaxing physiological diplopia exercises, and consider giving (at least as a temporary habit-breaking measure) +ve powered closework glasses to reduce the accommodative effort for near, with the idea that the vision shold be clear in the distance when they finish reading/computer, take the glasses off and look up.
I've not seen any authority recommend the use of long-term cycloplegic drops.

Answer 3

It isn't solved. They aren't very good at fixing this, they leave you to figure it out on your own.