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PubMed1975

[Converging squint in severe hypermetropia (author's transl)].

The valuation of 541 cases of convergent squint occuring together with a hypermetropia of more than +5 dpt showed that, the stronger the hypermetropia was, the higher was the proportion of primary microstrabismus to full-accommodative strabismus convergens. In patients who had hypermetropia of more than +8 D, the proportion of primary microstrabismus was 46%. Here the squint was always one-sided, so a high proportion of amblyopia could be expected. In 10% of the cases there was a spontaneous change from convergent to divergent squint - the angle reduction was up to 23 degrees, and could occur at any age. Factors, which seem to favour the appearence of a consecutive divergence, are: high hypermetropia of more than +8 D, increased ACA-ratio, onesided exclusion and vertical divergence. The measuring of the ACA ratio should be done at all orthoptic examinations.

Accommodation, Ocular↗
PubMed2003

[Status of low-vision rehabilitation for age-related macular degeneration by orthoptists in the North of France].

AIM OF THE STUDY: To evaluate the status of low-vision rehabilitation carried out by the orthoptists in the North of France. This study was a preliminary step in setting up a network between different vision professionals for the management of age-related macular degeneration (AMD) the North of France. METHODS: The ASO (Association Septentrionale d'Ophtalmologie) conducted a survey funded by the URCAM (Union Régionale des Caisses d'Assurance Maladie) with the FAQSV (fond d'aide à la qualité des soins de ville). The survey was based on the analysis of two forms sent to orthoptists of the North region of France. RESULTS: The survey analyzed 46 responses (a representative sample with 69% responses) providing a description of the orthoptists of the North of France: 19% males, 81% females whose mean professional experience was 13.3 years. Thirty-four percent of the orthoptists have had training in low-vision rehabilitation. This training was given during the university courses for 21% of responders and during a postgraduate course for 79%. Of the orthoptists surveyed, 64% worked in a private context, 9% in a public context, and 27% in both public and private contexts. Their main activity was in their own private practice for 60%, in an ophthalmologist's office for 20%, in a public institution for 16%, and a private institution for 4%. The mean number of patients treated was 70 per week per orthoptist, with 21% working mostly with children, 36% working mainly with adults between 16 and 60 years of age, and 7% with the elderly, whereas 36% reported no specificity related to patient age. The mean number of patients dealt with for low vision related to AMD was 4.1 per month per orthoptist. The average number of patients dealt with for low vision with no relation to AMD was 1.5 per month. The prescriber of low-vision rehabilitation was an ophthalmologist for 88.9% of the orthoptists and a general practitioner for 11.1%. Questions addressed to AMD patients: at the beginning of the survey, 83.8% of the patients did not have sufficient visual acuity to be able to read a text of current size (Parinaud 4); 40.4% of the patients required help for everyday life, and 59.6% were autonomous. For 7.1% of the patients, low-vision rehabilitation was carried out less than 1 month after the stabilization of retinal lesions, but in 35.3%, rehabilitation was carried out more than 2 years after lesions were stabilized. The main request of the patients involved improvement of near vision (89.9%). CONCLUSION: This survey will be a preliminary step in setting up a regional health network coordinating the ophthalmological and orthoptic management of AMD.

Aged↗
PubMed1959

Nonsurgical treatment of convergent strabismus.

It is generally agreed that surgical treatment of convergent strabismus should be withheld until all other less traumatic approaches have proved ineffectual. There are four categories of nonsurgical treatment. One is psychiatric. Too often psychiatric problems in the causation of convergent strabismus are either overlooked or unrecognized. Another is the proper employment of optical devices. For example, spectacle lenses to eliminate the need for excessive accommodation with its associated convergence excess, and the employment of prisms in the lenses to permit the two eyes to see as a unit even though they may not be properly anatomically oriented. Another kind of treatment is orthoptics, the use of exercises and rather complex optical equipment in a laboratory to train the patient in coordination between the two eyes. Treatment with drugs is based on the fact that certain drugs reduce the effort necessary for accommodation (much as eye-glasses do) and therefore lessen the stimulus toward convergence which may possibly tend toward the development of convergent strabismus.

Accommodation, Ocular↗
PubMedDate not supplied

Study of primary convergence insufficiency.

The present study was done to find out the incidence of primary insufficiency of involuntary convergence and evaluate the relative efficacy of synoptophore treatment against home exercise in its management. During the period of study, 2162 cases in the age group 15 to 35 years were studied for convergence in detail. It was found out that the incidence of primary convergence insufficiency is quite high (7.7% of total orthoptic clinic attendance). It commonly affects those who are constantly engaged in near work. Response to synoptophore exercises and home exercises is comparably equal. Recurrence of the ailment after stopping the exercises is not uncommon.

Adolescent↗
PubMed1991

[Imbalance of the postural system studied by light stimulation in children with strabismus].

The postural displacements on a statokinesimetric plateform of squint-eyed children during short monocular lighted stimulations show that their postural regulation is different from that of normal children of the same age. The provoked amplification of the displacements is larger, their direction is no more systematized but once adopted it remain stable. The orthoptic treatment associated with prismus lenses and postural reeducation often allows to double their postural performances.

Adolescent↗
PubMed1990

[Visual rehabilitation of adult patients after unilateral cataract extraction].

The influence of correcting soft contact lenses and pleoptic-orthoptic exercises on the improvement of the visual acuity and acquiring of binocular vision was analyzed in 22 patients aged 17-65 years after unilateral cataract extraction. Visual acuity of between 5/5 and 5/16 was attained in 88.6 p.c. of patients, binocular vision in 85.9 p.c. Poorer results were observed in persons with a diminished transparency of the ocular media caused by injury as well as in younger individuals after congenital cataract surgery.

Adolescent↗
PubMed1990

[Improving the function of the visual system in children with aphakia].

Systematic reeducation by pleoptic-orthoptic exercises was performed in children with posttraumatic and congenital aphakia for the improvement of the visual acuity, normal retinal fixation and binocular vision. The treatment comprised 244 children aged 1-16 years who were formerly given a correcting contact lens on the aphakic eye. In the result of rehabilitation a visual acuity of over 5/16 was attained in 79.5 per cent of cases, a normal retinal fixation in 73.77 per cent and the binocular vision in 46.31 p.c. Better results were obtained after treatment of a posttraumatic cataract, poorer results after extraction of a congenital cataract.

Adolescent↗
PubMed1986

The efficacy of visual therapy: accommodative disorders and non-strabismic anomalies of binocular vision.

Questions concerning the effectiveness of therapeutic intervention designed to modify the function of an individual's visual system have been raised by professional groups, consumer groups, insurance carriers, students, educators, as well as "pure" scientists. This paper examines the available literature in order to answer the question, "Is there evidence that 'orthoptics' or 'vision therapy' causes changes in an individual's accommodative or vergence eye movement systems?" This review neither examines alternative methods of causing these changes nor provides information concerning which particular techniques are most effective, although the literature does provide such information. Certain conditions are explained to aid the student and lay-reader in understanding the literature cited. The literature cited substantiates that visual therapy can modify visual functions and also points out the relationship of these changes to the relief of certain symptoms.

Accommodation, Ocular↗
PubMed1979

Prevention and care of strabismus in infants and pre-school children.

Care of children at risk of developing strabismus is discussed. Recommended care consists of parental counseling combined with early and periodic examinations. Examinations should begin by age 3 weeks and continue at 3-6 month intervals until the child reaches age 5. Treatment of strabismus or amblyopia should begin as soon as these conditions exist. Using recent electrophysiological research as a background, a model care for infants with congenital strabismus is presented. Care reports are presented describing results of orthoptic treatment of non-congenital strabismus.

Age Factors↗
PubMed1979

[Better prognosis for amblyopics by means of full prismatic correction after monocular treatment (author's transl)].

Binocular training with full prismatic correction after the monocular therapy by occlusion brings a further improvement of the visual acuity as well as shown in a study of 29% (138 cases) of 469 selected cases with binocular problems and 43% (260 cases) of about 600 unselected cases of squint actually in treatment in the practice and orthoptic years the strength of the prisms is determined with the monocular covertest, in elder patients with the Polatest. If the amblyopia is connected with squint, an operation will only be performed after the amblyopia is improved and some degree of binocularity is reached by means of prisms. - 80% of the selected and 48% of the unselected cases reached a visual acuity of 1,0 on the amblyopic eye, including originally severe cases with eccentric fixation. In about 80% of all cases binocular single vision and stereopsis were reached. Failures were mainly due to remaining eccentric fixation, mostly connected with severe ARC, too advanced age at ting the prisms, too long intervals between controls etc.) - Finally, the importance of cooperation with an orthoptist and the social medical aspects of better chances for amblyopics are accentuated.

Adolescent↗
PubMed1978

[Diploptics - brand-new system of concomitant squint treatment (author's transl)].

The present paper exposes the shortcomings of orthoptics and proposes an original system of concomitant squint treatment named diploptics. This system is based on the new conception of the role of bifixation in the physiology and pathology of binocular vision. The major principle of diploptics is to induce diplopia under natural conductions and further to "enliven" or develope the ability to overcome it with the help of the optomotor fusion reflex and thus to recover the auto-control mechanism of bifixation - the basis of the normal binocular vision. To realize this principle a number of methods are suggested. A trial of these produced hopeful results.

Accommodation, Ocular↗
PubMed1982

[Physiological or sensorial approach to the early treatment of strabismus (author's transl)].

Results obtained in 142 cases out of a total of 1.460 patients with non-accommodative strabismus treated and follow-up for 15 years are analyzed. Basic treatment was sensorial, started at a very early stage, supplemented by surgical correction of the mechanical defect. Complete recovery was obtained in 76 p.cent of cases, good vision with a very small angle (2-4 dpt.) microtropia in 17 p.cent, and a residual angle of 8-15 dpt. ni 7 p.cent. Similar results were obtained in small angle and congenital strabismus cases: following orthoptic therapy alone in 25.7 p. cent of patients, and after a single operation in 69.2 p.cent. No case of secondary divergence occurred and results remained stable during the 15 year period due to the fusion lock. It is the only treatment of surgical undercorrections and of the rare recurrences, and probably a causal treatment of spasms. Results suggest that sensorial physiological treatment should be basic treatment; A.R.C. should become as obsolete as excentric fixation amblyopia; this treatment emphasizes the crucial role of the orthoptist who really cures the strabismus. It is the "historical transition" of Jampolsky.

Adolescent↗
PubMed1981

Intermittent exotropia: is surgery necessary?

Sixty cases of intermittent exotropia were studied to compare the outcome of those patients treated medically with the outcome of those patients treated surgically. Below 30 prism diopters of intermittent exotropia, there is a high functional cure rate in both groups. Preoperative orthoptics did not lead to a surgical overcorrection. And finally, central fusion is not essential for a clinical cure.

Adolescent↗
PubMed1977

Anaglyphic T.V. ping pong antisuppression trainer.

Orthoptic therapy often entails the repetitive usage of detailed and complicated training procedures. Amblyopia and antisuppression therapy in particular may require weeks or months of trainning. A multipurpose training device has been constructed from commercially available components and promises to maintain a high level of patient interest and cooperation throughout the training procedure.

Amblyopia↗
PubMed1998

[Functional recuperation in unilateral congenital cataract--a clinical case].

The management of a monocular congenital cataract is dominated by the problems of amblyopia, always present. The paper shows the case of an eight years old child, who was operated when he was 6 month of age for monocular congenital cataract. After YAG-Nd treatment of secondary cataract, aerian correction and intense pleoptic and orthoptic treatment, the visual acuity rise up to 1/4, when was possible to made an IOL implantation. We consider that is important to try to solve the monocular congenital cataract, even at higher ages, because the results is possible to be satisfactorily.

Cataract↗
PubMed2005

Clinical profile of amblyopia in Pakistani children age 3 to 14 years.

OBJECTIVE: To study the clinical profile of amblyopia in children age 3 to 14 years. DESIGN: A cohort study. PLACE AND DURATION OF STUDY: The study was conducted over a period of two years from June 2001 to June 2003 at Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, Pakistan. PATIENTS AND METHODS: This study included 316 children. Visual acuity was tested with Snellen type and Lea symbols chart according to the level of cooperation of the children. Cycloplegic refraction and orthoptic assessment was performed on all children. RESULTS: One hundred and eighty-two children were between 3 to 8 years age and 134 were between 8 to 14 years. Mean age was 8 years. One hundred and twenty children had strabismic amblyopia, 136 children had anisometropic amblyopia, while 60 children had combined mechanism amblyopia (strabismus and anisometropia both). CONCLUSION: The results indicate the importance of screening school-going children for refractive error and amblyopia and the importance of a future prospective study on the magnitude, cause and treatment of amblyopia at more treatable age.

Adolescent↗