Pseudomyopia post blunt ocular trauma: A tale of two cases

Dear Editor, Journal of Clinical Ophthalmology and Research Blurring of vision after an eye injury is a significant concern, yet not all cases of post-traumatic myopia are permanent. The phenomenon of transient pseudomyopia following blunt ocular trauma remains underrecognized in clinical practice. We present two cases illustrating this reversible form of myopic shift and emphasize the importance of careful observation rather than immediate optical correction.[1] A 17 Year male athlete was hit in the eye by a tennis ball. He experienced sudden blurring of vision, damage to the iris sphincter, and retinal commotio with initial visual acuity of 6/24 in right eye with acceptance of -0.75DS. In a separate case, a 20-year-old cricket player was directly impacted by a cricket ball and developed Berlin’s edema along with decreased vision with initial visual acuity of 6/24 with acceptance of -1.25DS/-0.50DC x 110. Both patients showed a myopic shift in refraction right after the trauma. Fortunately, these refractive changes went away on their own in the following weeks. They both fully regained their vision and did not need corrective lenses. Pseudomyopia is marked by a temporary refractive problem caused by involuntary ciliary muscle spasms, without any changes to the eyeball or cornea. This issue with focusing can briefly impact distance vision and visual performance, particularly for athletes and others involved in visually demanding tasks. It is important to tell the difference between pseudomyopia and true (structural) myopia to avoid giving unnecessary glasses or contacts and to ensure proper care.[2,3] Blunt eye trauma often causes this condition by stimulating the parasympathetic nervous system, which results in a lasting spasm of the ciliary muscle. Research shows that these shifts toward nearsightedness from trauma are usually mild to moderate, resolve within a few weeks, and are best treated with observation or short-term medication. Cycloplegic refraction and regular evaluation are crucial to tell the difference between temporary pseudomyopia and real refractive errors.[3–5] Our cases highlight an important practical point: Most instances of myopia after blunt trauma can reverse on their own and do not require immediate correction with lenses or other treatments. Rushing to correct vision can impact patient care and result in misdiagnosis. Regular monitoring and patience are usually the best approaches, as most cases tend to resolve naturally when ciliary muscle function normalizes. We emphasize the importance of increased clinical awareness of transient pseudomyopia following blunt eye injuries. A thorough refractive assessment, cycloplegic testing, and consistent follow-up should occur before making any decision about prescribing corrective lenses. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Data availability statement The data supporting our findings are available for access. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.