Whiplash-Associated Accommodative Spasm Treated with Gamma-Amino-Butyric Acid Agonist

Abstract

Spasm of the near reflex is characterized by miosis, excessive convergence and accommodative spasm (pseuomyopia) that usually occurs, on a functional basis, in young adults with underlying psychiatric disorders (anxiety, depression, hysteria). When this disorders occurs on a functional basis, miosis is always present as well as variable degrees of convergence and accommodation with pseudomyopia. Accommodative spasm can also occur after a head injury as isolated entity of spasm of the near reflex and causes symptoms (blurred vision, headache, and nausea) that are reversible after cycloplegia. Spasm usually resolves spontaneously after 1-2 years from the head injury, but in some cases may persist for a long time and cycloplegics not provide an effective and definitive solution to the problem. We report a patient with a whiplash-associated accommodative spasm and pseudomyopia, treated with GABA-B receptor agonist (Baclofen) that improved accommodative spasm.