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PubMed1979

[Advances in the field of surgical therapy of strabismus (author's transl)].

During the past 10 years the surgical treatment of strabismus has received different new impulses. Two fundamental novelties in this field have been reported and three not unimportant contributions towards the facilitation of, or improvement in therapy: Cüppers described a method to improve and/or eliminate the dynamic squinting angle in cases of ocular nystagmus by the so-called "Fadenoperation" and Aichmair demonstrated the possibility of re-establishing the function of a traumatically paralyzed abducens muscle by means of muscular neurotisation. Aichmair and Abel discovered in a comparative study that there is no necessity to bandage patients after a squint operation; this is of especial importance in small children as there need no longer be any fear of the postoperative binocular bandage. Aichmair and Fries demonstrated a simple method for the precise measurement of the volume of implantates to eliminate enophthalmus after blow-out fractures; this helps the surgeon to avoid over- or undercorrection. They stressed, furthermore, the importance of the right shape of the implantate. de Decker published a new method of tucking of the superior oblique and of recession of the inferior oblique that facilitates the operation and at the same time enables more accurate dosation.

Abducens Nerve Injury↗
PubMed1979

[Comparative refractioning in juvenile strabismus patients. Experience with the Auto-Refractor 6600 (author's transl)].

122 strabismus patients have been refracted in order to compare the cycloplegic effect of Cyclopentolat-HCl (Zyklolat) and atropin. In young patients the cycloplegic effect of Zyklolat is not as sufficient as that of atropin is. Moreover the positions of cylindrical axes show differences up to 30 degrees under Zyklolat in comparison with atropin. On the other hand we give a report of our experience using the Auto-Refractor 6600, the before-mentioned measurings were performed with. -- The important field of the Auto-Refractor is the routine refractioning of co-operative patients. Using it on young children which are unco-operative the Auto-Refractor is not as sufficient as we hoped it to be.

Accommodation, Ocular↗
PubMed1984

Managing strabismus in endocrine eye disease.

In Graves' ophthalmopathy, now considered a separate autoimmune disorder, 15% of patients have a motility disorder. This is usually a restrictive strabismus, most often involving the inferior rectus muscle, and is diagnosed with the aid of forced duction testing, saccadic velocity measurement, binocular visual field testing and prism cover testing. Adjustable sutures may be used, depending on the intraoperative findings. The case presentations in this paper demonstrate the principles of diagnosis and treatment.

Adult↗
PubMed1984

[History of strabismus surgery].

The history of strabismus surgery starts from the end of the eighteenth century. The first surgical trials consisted of performing myotomies of the medial rectus. Although Taylor from Great Britain could be one of the first to be mentioned, it was Dieffenbach from Germany who accomplished the first official myotomy in 1839. He is followed by many authors as Roux, Velpeau in Paris, and Bonnet in Lyon, the latter performing tenotomy instead of myotomy. In 1849 Guerin performed muscular advancement. In 1883, de Wecker described the muscular pleating, and Blascowiczs the muscular resection. Thus, by the end of the nineteenth century, the surgical treatment of esodeviations was supported by methods aimed to weaken the medial rectus (tenotomies, myotomies) and to strengthen the lateral rectus (advancement, pleating and resection). During twentieth century, progress achieved in anesthesiology and the quality of suture material led Jameson (1922) to substitute tenotomy by muscular recession. Since then, the surgery of squint has never been modified basically up to 1970 when Cuppers created the retro-equatorial myopexy. Thus, two kinds of surgical technics are currently available to surgeons: classic surgery, recession, resection and their variants, dealing with the static component of the deviation angle, and the Faden Operation of Cuppers struggling against the dynamic or innervational component.

Adult↗
PubMed1984

Noncomitant strabismus: evaluation and management.

A model is presented for the functional evaluation and management of noncomitant strabismus. The model considers the identification of noncomitancy and the differences in approach to evaluation and management depending upon whether the involvement is recent or long-standing.

Diplopia↗
PubMed1983

Spatial characteristics of static and dynamic stereoacuity in strabismus.

The spatial and temporal organization of stereoscopic depth perception were compared in normal and strabismic observers. The minimum and maximum disparities for stimulating static and dynamic stereopsis in strabismus were examined as a function of spatial separation of disparate stimuli. Disparities and their spacing were produced by spatial modulation of two vertical lines viewed haploscopically. Most strabismics had normal upper disparity limits but elevated static and dynamic stereothresholds. Moderate stereothreshold elevations (100 arc sec) were constant for spatial separations greater than 15 arc min. Two new types of spatial crowding effects upon stereopsis were observed. The first type resulted from the constant elevation of the disparity threshold. The second type consisted of a reduced maximum disparity limit for stereopsis. In both cases, the constriction of the range of perceivable depth produced a reduction in the spatial and temporal frequency limits for depth perception. Clinical tests of stereoacuity that crowd stimuli closer than 0.25 degree underestimated the strabismic patients' potential stereoacuities by a factor of 2 to 4. Similarly, tests of dynamic stereopsis that use temporal frequencies greater than 1 Hz will underestimate optimal dynamic stereoacuity.

Depth Perception↗
PubMed1982

Success in strabismus therapy: a literature review.

The purpose of this study was to review the literature pertaining to non-surgical cure rates for strabismus published since 1958 and compare it to Flom's prognostic model. However, no studies were found that could be compared directly to Flom's model. One reason for this was due to the use of different definitions of a cure by different clinicians. Another reason was the failure to categorize the data according to the effect that retinal correspondence, frequency, and direction of the deviation had on the cure rates. From the studies which specified Flom's functional cure or its equivalent, it was determined that strabismic cure rates could be broken down as follows: Constant esotropia-29%; Intermittent esotropia-73% Constant exotropia-53%; Intermittent exotropia-62% Suggestions were made for the reporting of data to make future research more comparable and useful to the practitioner.

Adolescent↗
PubMed1982

Strabismus, amblyopia, and dyslexia.

Accurate ocular assessment in the pediatric patient can be a challenge to the primary care physician. Guidelines are suggested for ocular evaluation in children of varying ages. Strabismus, amblyopia, and dyslexia are among the most common ocular problems seen in children; medical, surgical, and educational means to treat these disorders are emphasized.

Amblyopia↗
PubMed1978

Biofeedback treatment of strabismus: case studies.

This project demonstrates the use of neuromuscular reeducation biofeedback as a treatment for strabismus. Of the three subjects treated, an exotrope and an esotrope were cured according to pre-defined criteria and an exotrope with a dense monocular cataract was improved. Treatment consisted of monitoring eye positions using infrared sensors and feeding back information on relative ocular deviations coded in the form of a tone.

Adult↗
PubMed1982

[Primary divergent strabismus: Reflections after thiry years experience of treatment (author's transl)].

Certain specific points concerning the treatment of divergent strabismus are discussed, particular emphasis being placed on the importance of the sensorial element, which must be restored to normal levels in order to obtain complete recovery. Orthoptic reeducation is a highly effective necessary stage, and should be attempted in all its forms. Excellent or good results have been obtained in 85 p. cent of cases, 1 half of these by the use of orthoptic exercises alone.

Humans↗
PubMed1981

Biofeedback enhanced strabismus therapy.

Previous work, conducted under laboratory conditions, has shown that biofeedback using infrared eye position monitoring can be used to successfully treat strabismus. For the present study, seven matched pairs of strabismic patients were selected. One member of each pair received biofeedback enhanced vision therapy while the other member received traditional vision therapy. Cover test data obtained during each training session showed an advantage in using biofeedback enhanced training in several but not all cases. It is suggested that the optimum use of biofeedback may be prior to traditional training rather than integrated with it.

Accommodation, Ocular↗
PubMed1980

[The mechanism of inhibition of binocular vision in convergent strabismus (author's transl)].

The mechanism of inhibition of binocular vision (at a cortical level in the Pavlovian sense) in convergent strabismus is described. The study concerns both those patients whith no amblyopia and those whose amblyopia has been cured. Part one of the article describe the clinical characteristics of this cortical inhibition as shown by the polarised light stereoscopic projector. Some basic concepts with this therapeutic application are described in part two. In this paper the author suggests a relationships between the severity of inhibition of binocularity and the degree of disturbance in spatial localisation. The greater the inhibition at a cortical level, the more disturbed is the localisation of objects in space in binocular vision. The treatment of inhibition must include precipitating causes that is to say the disturbed binocular relationships of abnormal retinal correspondence and is complete when cortical inhibition and abnormal retinal correspondence has been completely rectified. On the other hand there are occasions when it is not possible to eliminate abnormal retinal correspondence, this is especially true in older patients, and under this circumstances, it is better to accept inhibition of binocular function than to have diplopia.

Diplopia↗
PubMed1980

Simultaneous correction of blepharoptosis and exotropia in aberrant regeneration of the oculomotor nerve by strabismus surgery: a new, simplified ptosis correction for selected cases.

Selected patients with blepharoptosis and exotropia with aberrant regeneration of the oculomotor nerve can achieve acceptable cosmesis by simple strabismus surgery. Patients with good lid position on attempted contralateral gaze are candidates for this new approach. With aberrant regeneration of the oculomotor nerve, the affected levator frequently becomes pathologically yoked to the contralateral lateral rectus muscle. In these cases, the ecotropia is corrected by a recess-resect procedure primarily or exclusively on the contralateral fixing eye such that postoperatively. The fixing eye is "abducted" by the patient to the primary position, and the ptotic lid elevates simultaneously.

Blepharoptosis↗
PubMed1981

Naturally occurring strabismus in monkeys (Macaca nemestrina).

Seven naturally strabismic monkeys (Macaca nemestrina) was identified. Five of these monkeys were examined by ophthalmologists. No ophthalmoscopically obvious cause for the squint was found in any case. Of those five animals, two were tested behaviorally on visual responsiveness and visual acuity. The acuity of both eyes of both monkeys was somewhat poorer than normal. In addition, an amblyopia of 0.8 octaves was found for one monkey and 0.6 octaves for the others. The existence of naturally strabismic monkeys supports the utility of the macaque as an animal model for studying strabismus and amblyopia.

Amblyopia↗
PubMed1978

Orthoptic treatment of strabismus.

The purpose of this paper will be to carefully examine the effectiveness of orthoptics as a viable treatment modality for strabismus. It will be necessary to first examine the scope of this problem and the significance of functional cure. A short discussion of perceptual and psychological effects will be included. A review of pertinent literature and an analysis of the data will be presented. Any commonalities or generalizations which can be identified will then be discussed and analyzed. Finally, the training of the optometrist in orthoptics and associated subjects will be examined to demonstrate the qualification of the optometrist to administer orthoptics in the treatment of visual anomalies.

Adolescent↗
PubMed1994

[Treatment of strabismus in ambulatory surgery].

Since april 1993, we have an out-patient surgery department in our university hospital. We report our experience of out-patient surgery in 80 strabismic patients> We have divided the 80 patients in a pediatric group and an adult group. We describe the conditions of admission for out-patient surgery, the method of anesthesia, the development of the procedure. Surgical techniques do not differ from those used in hospitalized patients. We report our statistics concerning age, diagnosis, type and length of surgery of our 80 patients. The lack of complications and the satisfaction of our patients convince us to carry on out-patient surgery for strabismus.

Adolescent↗
PubMed1995

Refractive error and axial length in a primate model of strabismus and congenital nystagmus.

PURPOSE: To evaluate the development of refractive error and axial length in a primate model of sensory strabismus and nystagmus. METHODS: Four macaque monkeys had alternating tarsorraphy beginning within 24 hours of birth. One eye was closed for 25 days, and when it opened, the second eye immediately was closed for the next 25 days. Cycloplegic refractions and axial lengths were determined prospectively for three animals for 1 year or more. These data were compared to those of three unsutured control macaques raised under otherwise similar conditions. RESULTS: Each experimental animal developed exotropia and nystagmus. The first occluded eyes were significantly more hypermetropic than the control eyes at 1 month of age (+7.25 D +/- 1.95 D versus +1.92 D +/- 1.27 D; P < 0.02) and remained significantly more hypermetropic throughout the study. The second occluded eyes were more hypermetropic than the control eyes at 1 month (+2.42 D +/- 2.13 D versus +1.92 D +/- 1.27 D; P = 0.20), but less hypermetropic than the first occluded eyes. The rate of emmetropization was slightly faster for the first occluded eyes than for the control eyes (-0.12 D/month compared to -0.03 D/month). The mean axial length measurements of the experimental and control eyes were the same at 1 month, and their rates of change over time were identical. CONCLUSIONS: Persistent hypermetropia was produced by a brief period of reverse neonatal eyelid closure in a model of congenital-like nystagmus. It is suggested that infantile lid closure, nystagmus, or amblyopia after neonatal visual disruption may be associated with a failure of normal emmetropization.

Animals↗
PubMed1995

[Creatine kinase in strabismus surgery].

The paper presents results concerning serum creatine kinase (CPK) activity before and at different times following the surgery of extraocular muscles at concomitant strabismus. The operation evokes statistically significant increase of CPK activity which tends to normalize during healing processes.

Adolescent↗