 Spasm of the near free flex is largely a non-organic disorder. Now look at this, the patient is evoking the near response with convergence and myosis. When you take this patient through gaze, you would suspect that perhaps there is a limitation with ABduction, but observing the myosis gives you the clue that the patient is evoking the near response. This shows up very nicely, you can see that myosis. So this is not an ABduction deficit per se. It's not due to six nerve limitation, it's not due to lateral rectus muscle problems, it's from evoking the near response. Don't get fooled by this syndrome and think that the patient has a six nerve palsy. You can occlude one of the eyes, have the patient stare at your nose, turn the head from side to side and easily demonstrate that the deductions are in fact full.