This study highlights the role of cycloplegic refraction in the detection of accommodative spasm and the use of tropi-camide 1% as cycloplegic and single vision plus lens for its management. This was a case study carried at tertiary eye hos-pital in Kathmandu, Nepal. In this study, 2 subjects presenting with complain of sudden onset of diminution of vision for near and distance along with asthenopic symptoms having history of prolonged near work were recruited. Pre-cycloplegic refraction showed fluctuating myopic refractive error which after cycloplegia showed a significant hyperopic shift. Single vision plus lens (base on post-mydriatic treatment) giving optimal vision for near and distance along with tropicamide 1% twice a day basis and abstinence of triggering factor was started as initial treatment modality. Subjects were kept under close surveillance and followed up fortnightly over 2 months. During this period, the dosages of tropicamide were gradu-ally tapered based on symptomatic relief of patient and no recurrence of the condition was observed in both subjects for next 2 month.
Keywords: Accommodative spasm, Nepal, pseudomyopia, single vision lens, tropicamide.