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PubMed1992

Optometric management of optically induced consecutive exotropia.

A 5-1/2 year old black female initially presenting with a moderate angle esotropia and latent hyperopia developed a large angle constant exotropia 2 years after final correction of her refractive error. The occurrence of consecutive exotropia as a result of optical correction of hyperopia has been documented infrequently in the ophthalmologic literature and has rarely been mentioned in the optometric literature. While the overall risk for occurrence of this complication from correction of hyperopia may be small, it is a problem which may occur and can be avoided. Unfortunately, there is only limited information about the various risk factors that should be monitored to avoid the occurrence of an optically induced consecutive exotropia. What is available with regard to evaluation and management is scant, and there are no case reports emphasizing optometric management which includes the use of lenses, occlusion and vision therapy. The purpose of this paper is to present a case report of optically induced consecutive exotropia followed by a summary of the available information from the optometric and ophthalmologic literature. This combined information will aid optometrists managing these patients to avoid the occurrence of this problem and better understand the various management aspects when it does occur.

Accommodation, Ocular↗
PubMed2005

The outcomes of horizontal strabismus surgery and influencing factors of the surgical success.

OBJECTIVES: To evaluate the surgical outcomes of horizontal strabismus and identify the influencing factors of the surgical success. MATERIAL AND METHOD: The medical records of 304 patients who underwent their first strabismus surgery for treatment of horizontal deviation at Siriraj Hospital were reviewed retrospectively from January 1998 to December 2003. The main outcome measure for successful surgery was defined as eye deviation 10 prism diopters or less at 6 weeks post-surgery. The outcomes of postoperative binocular function and visual acuity improvement were also evaluated. The pre operative deviation, diagnosis, binocular function, visual acuity and age were analyzed as influencing factors of surgical success. The patients were divided into two groups, the first group was 6 years or less (161 cases) and the second group was older than 6 years (143 cases). The statistical methods for analysis the data were Chi-square test, Mann-Whitney U test and Logistic regression. RESULTS: The follow- up period was from 3 to 12 months. 187 patients (61.5%) for esotropia and 117 patients (38.5%) for exotropia were identified. Mean patient's age was 10.5 +/- 10.2 years (median 6, min 0.5, max 53), mean preoperative deviation was 44.9 +/- 16.6 prism diopters and mean VA was 20/30 (no PL, 20/20). The success rate was 62.0% for esotropia and 57.0% for exotropia. There was no statistical difference between the two groups of diagnosis. The average final deviation postoperative in the success group was 6 +/- 4.9 prism diopters. The comparison of difference visual acuity between pre and post-operation showed no statistical significance but the presence of binocular vision was increased in number of patient by two times. The complication rate was 0.7% (2/304), one case showed conjunctival wound dehiscence and the other had globe perforation. Re-operative rate was 12.9% (39/304) after one year. CONCLUSION: The surgical success rate of horizontal strabismus surgery was 60.2% and revealed no statistically significant improvement of visual acuity after surgery. The successful surgery was related to the age younger than 6 years and preoperative deviation less than 30 degrees.

Adolescent↗
PubMed1991

The effect of excessive add power on the acceptance of progressive addition lenses.

Twenty-nine subjects wearing Varilux Plus (Varilux 2) or Varilux Infinity lenses were drawn from the UAB School of Optometry primary care clinic population. Using a double-masked, randomized cross-over design, subjects wore one pair of progressive addition lenses (PALs) with a normal add and one pair with the add overplussed by 0.50 D. Subjects wore each pair of lenses for 1 week. Twenty-five of the 29 patients preferred the normal add over the overplussed add. In all subjective response categories the normal add was rated higher than the overplussed add.

Adult↗
PubMed1991

The effect of chronic one-eye patching on ocular myoclonus.

Ocular myoclonus developed in our 34-year-old patient 4 months after massive brain stem hemorrhage due to eclampsia. On chronic patching of the left eye, the vertical pendular nystagmus in the fixating right eye disappeared, whereas the covered eye was esotropic. While fixating, the left eye showed horizontal pendular nystagmus. With both eyes fixating, the right eye presented markedly vertical pendular nystagmus and the left eye a horizontal pendular nystagmus. It seems that chronic patching of one eye has a beneficial modulating effect on the vertical pendular nystagmus in the fixating eye.

Adult↗
PubMed1991

[Active or postural prisms].

Oculomotor visual input of the postural system can be modified with a small powerful prism from 1 to 4 dioptries. The determination of features acting on postural tonus through visual and oculomotor input is difficult. It is necessary to examine postural and oculomotor consequences of each optical correction.

Eyeglasses↗
PubMed1991

Vision screening of children: a review of methods and personnel involved within the UK.

The validity of vision screening of children for amblyopia, squint and significant degrees of ametropia is reviewed. The suitability of the tests used in screening, the age at which they are applied and the personnel involved is assessed. Some suggestions for improvement are made with particular reference to the optometrist's role, especially in view of the proposed child health surveillance scheme to be undertaken by selected general medical practitioners.

Adolescent↗
PubMed1990

[Diagnosis and treatment of ophthalmoplegia].

The author discusses the signs and symptoms appearing in the course of so called noncommittant squints. Noncommittant squints are divided into squints caused by paresis or by a total paralysis of the motor muscles. One can divide the therapeutical procedure into the conservative and surgical treatment. The conservative treatment is carried out for one year since the onset of the palsy. After 12 months in the case of a lack of improvement a surgical intervention is performed. Surgical operations are divided into 3 types: 1) Rotation of the eye, that is to say operation of a recession-resection type--on the affected eye, 2) the principle paresis-counter-paresis or interventions performed on the muscles of the healthy eye, 3) transpositions of the muscles.

Eyeglasses↗
PubMed1990

[Treatment of vertical strabismus using binarimetry].

The paper analyses results after treatment of patients with vertical squint (53 persons) using a principally new method--binarimetry, as one of diploptic methods. All patients had residual vertical deviation after surgical treatment or a small angle (to 10 degrees). The device and the method of treatment are described. In the most of patients, binocular vision was restored (77.3%) on account of development of vertical fusional reserves and correction of residual deviation.

Adolescent↗
PubMed1990

The importance of multiple treatment modalities in a case of divergence excess.

Divergence excess strabismus is a fairly common anomaly of binocular vision, characterized by constant or intermittent exotropia at distance, absence of significant amblyopia, and normal stereopsis at near. Optometric vision therapy is often effective in treating this condition. In contrast to the emphasis orthoptists (under ophthalmologic supervision) place upon pathological diplopia awareness, optometric vision therapy emphasizes development of sensory fusion and proprioceptive cues to eye alignment. A case is presented in which pathological diplopia awareness and surgery were needed to produce a functional cure after the patient failed to achieve consistent eye alignment using the regimen commonly advocated by optometrists.

Child↗
PubMedDate not supplied

Seeing it straight.

Explore the source record for details and available documents.

Female↗
PubMed1989

The effect of prolonged monocular occlusion on latent nystagmus in the treatment of amblyopia.

We recorded eye movements in 8 patients with latent nystagmus (LN) before and after 2 days of occlusion of the better eye. The slow-phase speed of the nystagmus (SPS) during fixation with the worse eye became lower after 2 days of occlusion of the better eye. However, the SPS during fixation with the better eye became higher after 2 days of occlusion of the better eye. The sum of SPS during fixation with the better eye and SPS during fixation with the worse eye remained the same. Oscillopsia complaints gradually disappeared over days during the occlusion. It seems likely that the alteration of the LN during prolonged monocular vision is caused by a slow-velocity bias of the neural integrator, a compensatory drift, generated by the flocculus using retinal-slip information. The difference between SPS during fixation with the better eye and SPS during fixation with the amblyopic eye in LN patients with amblyopia is probably also caused by this compensatory drift. As the compensatory drift changes its direction and magnitude slowly over days, it seems advisable to occlude the better eye in children with amblyopia and LN during days per week, and not during hours per day.

Adaptation, Ocular↗
PubMed1989

[Treatment of amblyopia with eccentric fixation of the vertical prism and occlusion--additional experience].

The authors evaluated a group of 202 patients with esotropia and eccentric fixation. On purpose they selected patients who were treated previously by another pleoptic method without success. The mean age of the patients was relatively high--7.9 years. The mean period of hospitalization was 54 days. Central fixation was achieved in 123 patients, i.e. in 60.8%. Vision became normal only in 40 children, i.e. in 19.8%. According to statistical evaluation by the U-test prisms with a power of 7 and 8 pdpt proved most useful. The method was successful in amblyopia with parafoveolar and paramacular eccentric fixation and acuity of vision of 0.5, 0.3 and 0.1. The treatment did not prove successful in poorer vision and more distant eccentric fixation. The authors do not recommend the use of vertical prisms with a power of 9 and 10 pdpt, as mentioned in their preliminary publication.

Amblyopia↗