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We write you to present a 20-year-old man with resistant spasm of accommodation without any organic cause treated with clear lens extraction (CLE) with phacoemulsification and multifocal intraocular lens (IOL) implantation. Spasm of accommodation is a rare condition characterized by sudden and involuntary sustained development of excess myopia without any accommodative stimulus. The etiology has not been precisely determined, but it is usually functional in origin and attributed to psychogenic factors triggered by anxiety, depression, emotional distress, or malingering. However, organic causes related to neurologic system affecting the brainstem, such as multiple sclerosis and metabolic encephalopathy or head trauma, have also been described [1-2]. The accommodative spasm is usually treated with cycloplegic or myotic eye drops, plus or minus lenses, but occluders and amytal abreaction may not …