This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Ophthalmology
[{'content': "A 14 years old boy complains of pain during reading. On examination, his both eyes are normal and vision with Snellen's reading is 6/5. He still complains of pain on occluding one eye. The diagnosis is – \nSelect and explain. \nA. Myopia, B. Pseudomyopia, C. Hyperopia, D. Emmetropia", 'role': 'user'}, {'content': 'Answer: B \nExplanation: This boy has :-\n\n\nEye strain during reading\nNo refractive error on examination (snellen:s reading is 6/5)\n\n\nThat means patient has compensated for his refractive error by hyperaccommodation, i.e. spasm of accommodation or pseudomyopia\n\nFollowing facts require some explanation\n\nActually this boy also has hypermetropia which is compensated by spasm of accommodation.\nIf the child will be examined for refraction under cycloplegia (relaxing the ciliary muscles) this compensation will not be there and the refractory error can be measured.\nSo, the boy is having hypermetropia but at the time of presentation, he is presenting with pseudomyopia due to excessive accommodation, i.e. compensatory correction of hypermetropia by excessive spasm of ciliary muscles.\nIn hypemetropia (when an error is not compensated)\nRefractive testing with or without cyclopegia will show hypermetropic type of refractive error.\nIn Pseudomypia (hypermetropia is compensated)\n\xa0Refractive testing without cyclopegia → No refractive error (because of compensation)\nRefractive testing with cycloplegia → Hypermetropia is manifested.\nIt is worth noting here that the above description was for spasm of accommodation which occurs in response to compensate the refractive error (hypermetropia).\nIn other situation where the spasm of accommodation is due to other causes (e.g. drugs causing ciliary spasm), the eye will become myopic (Pseudomyopia).\n\n\n\nSo, basically, spasm of accommodation causes myopia which results in:-\n\n\nIf hypermetropia is there → It will be compensated.\nIf no refractive error is there → Eye will become myopic.', 'role': 'assistant'}]