Spasm of accommodation, bilateral

This code describes an involuntary and sustained contraction of the ciliary muscle in both eyes, leading to a fixed focus at a near distance. This spasm prevents the eyes from relaxing to view distant objects clearly, resulting in blurred distance vision. It is a functional disorder of the accommodative system.

Use this code when documentation clearly indicates bilateral spasm of accommodation, often presenting with symptoms like asthenopia, blurred distance vision, and sometimes headache. This diagnosis is typically made after ruling out other causes of blurred vision and observing a sustained accommodative effort despite relaxation attempts.

• Ensure documentation specifies "bilateral" involvement; otherwise, use the appropriate unilateral code.
• Distinguish from accommodative insufficiency (H52.51-) or paralysis (H52.52-), which involve a lack of accommodative ability.
• Look for ophthalmologist or optometrist notes detailing objective findings of sustained accommodation or failed cycloplegic refraction.