spasm of accommodation

[michalk]

Hello,
My son is 9.5 years old
When he was 8 he complained to have double vision and was diagnosed to have convergence insufficiency or palsy.
We did eye therapy for 2 years but his vision became real bad
He complained to have blurred vision as well as double vision
After 2 years and many experts he was diagnosed to have severe convergence insufficiency or palsy and sever spasm of accommodation (up to -9).
With cycloplegic his vision is 6/6
The eye doctor and the optometrist told us he has a rare combination of 2 severe problems
He was treated in atropine 1%  1 drop a day together with multifocal glasses for 2 weeks  but after short time he had rare  severe side effects – behavior changes / hyperactivity / psychotic reactions  
The doctor changed to cyclopentolane but he had the same side effects
I think he might be sensitive to cycloplegic
We have stopped the treatment and the spasm became even stronger and the double vision is now for near and for distance
Should we try another kind of cycloplegic ?
What else can we do ???
He suffers a lot , can’t read and has severe head aces
Please advice

Kind regards
Michal

[John C Hagan III, MD, FACS, FAAO]

This is a very unusual problem and your best bet would be to seek care at the closest national class tertiary ophthalmology program you can get to. He may need the services of both pediatric ophthalmologist and neuro-ophthalmologists.

Since you don't list where you live what I'm talking about are programs like: Mayo Clinic, Wilmer Institute of Johns Hopkins, Bascom Palmer U of Miami, Emory, etc.

JCH MD