Fig. 20 Spasm of near reflex of volitional origin. A. Gaze forward in a young woman after an automobile accident. Note 4-mm pupils. B. Gaze right attempt shows abduction defect on right but constricted pupils. C. Another patient shows bilateral abduction “palsies” when asked to follow near target to either side. Note extreme pupillary miosis. While reading an acuity chart at 6 m, eyes were straight and full abduction was present with face turned to either side.