A New Treatment Approach For Accommodative Spasm Using Alpha Adrenergic Agonist (Brimonidine 0.2%).

To evaluate the effect of Brimonidine 0.2% eye drops in relieving the spasm of accomodation in patients aged from 18 to 25 years old.

Memorial Institute for Ophthalmic Research.

Thirty six eyes with spasm of accommodation of Eighteen patients aged from 18 to 25 years old were diagnosed in our refractive unit, Alpha agonist (Brimonidine 0.2%) eye drops was prescribed twice daily for two weeks due to its adrenergic effect on the ciliary muscles. Intraocular pressure was monitored weekly for all patients allthrough the study.

First follow up for non cycloplegic refraction using Autorefractometer was done after two weeks then the dose was reduced to once daily (morning drop) and the next follow up was four weeks after the initiation of tretment. The drops were then continued in a single morning dose for one more month.

The relief of symptoms and signs were our scale units.

On the first follow up after two weeks of initiation of treatment, 78% of patients showed relief of the spasm of accommodation, then the results went up to reach 82% of patients after four weeks of the initiation of treatment.

The Intraocular pressure (IOP) was monitored for all patients allthrough the study showing mild decrease (2-3 mmHg) after two weeks in 24% of cases which remain within the normal range for IOP.

No obvious side effects were found along our study, except for mild blepharoconjunctivitis that was easily treated in one patient. Unlike cycloplegic drugs, Brimonidine didn't show any blurring of vision on use.

Alpha adrenergic agonist (Brimonidine 0.2%) is an effective treatment for relief of accommodative spasm in patients aged from 18 to 25 years due to its adrenergic effect on the ciliary muscles in addition of being a neuroprotective tool with no obvious side effects.