Abstract

P 066

When there is no way forward?! “Sex, drugs and alcohol” – alternative therapies in accommodation and convergence insufficiency

Sturm V.^1,2, Niemüller I.², Berger R.^2
1Augenklinik, UniversitätsSpital Zürich, ²Augenklinik, Universitätsklinikum Hamburg-Eppendorf

Objective: Accommodation and convergence insufficiency (ACI) is a heterogenic disease often associated with functional but sometimes with neurological disorders, such as dorsal midbrain infarctation/hemorrhage and parkinsonism. It can also be related to infectious diseases, autoimmune diseases or be caused by diabetes, botulism or chronic alcohol abuse. Therapeutically promising in such cases of missing associations are reading and base-in prism glasses as well as orthoptic exercises. Therapy is often frustrating. We would like to demonstrate that it sometimes might be promising looking for therapeutic alternatives off the beaten track.
Methods: We present a longitudinal analysis of 25-year-old woman with a 10-year history of ACI. Treatments, such as reading or base-in prism glasses, and orthoptic exercises, did not show any long-lasting effect.
Even a surgical procedure for decompensating exophoria was unsatisfactory. Considering subjective observations of the patient during adolescence who recognized distinct improvement after having sex and on drinking small amount of alcohol we tried to copy the effect.
On admission, we confirmed the “alcohol therapy” with the same amount of a common beer. Additionally we tried to reproduce this with a non-alcoholic beer. Equally we offered Placebo, administrated as a “chemical alcohol” and a low dose of 40 mg propanol (a true chemical alcohol).
Results: Surprisingly we could confirm the “alcohol therapy” with the same amount of a common beer – convergence and accommodation were almost normal. We could even in a reduced form reproduce this with a non-alcoholic beer. Placebo, administrated as a “chemical alcohol” did not work. A low dose of 40 mg propanol was also effective.
Conclusions: Therapy in accommodation and convergence insufficiency is often less successful and patients' symptoms are troublesome and sometimes increasing. This may justify efforts to develop alternative therapies. Surprisingly, in a single case a small amount of a common alcohol (beer) just as a “chemical alcohol” have been shown to be an effective therapy in ACI, as opposed to the impairing effect after large amounts of alcohol.

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