Journal of Binocular Vision and Ocular Motility最新文献

{"title":"The Challenge of Strabismus Surgery for Patients with Hemianopic Visual Field Defects Associated with Ocular Deviations.","authors":"Pilar Merino, Lucas Gómez, Pilar Gómez de Liaño, Jacobo Yáñez-Merino","doi":"10.1080/2576117X.2024.2386204","DOIUrl":"10.1080/2576117X.2024.2386204","url":null,"abstract":"<p><p>Homonymous and heteronymous hemianopias associated with strabismus are a therapeutic challenge because surgery may result in diplopia, decrease the visual field (VF), and/or lead to recurrence of the deviation. We present four cases: two homonymous hemianopias and two heteronymous hemianopias. Of the four patients, three had exotropia and one had esotropia. The origin of hemianopias was neoplastic in two cases and traumatic in two cases. Strabismus surgery was performed in three cases, but only one case had a good result; recurrence of the deviation and diplopia occurred in the other two cases. In conclusion, exotropia may develop as a compensatory mechanism in a patient with congenital or early-onset homonymous hemianopia and realigning the eyes could reduce the binocular VF and cause diplopia. In heteronymous hemianopias, there is little risk of the surgery causing diplopia, but the strabismus is unstable because of the absence of binocular vision and vergence reflexes if VF loss includes the macula. Further, strabismus, in association with hemianopia, may be caused by coexistent cranial nerve and/or gaze palsy. The prognosis, objective, and results of the strabismus operation should be clearly discussed with the patients or their guardians before it is performed if hemianopias are present.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"104-110"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncertainties Regarding the Lifetime Reoperation Rate After Strabismus Surgery.","authors":"Christopher Theodore Leffler, Evan Silverstein, Carolyn May","doi":"10.1080/2576117X.2024.2385507","DOIUrl":"10.1080/2576117X.2024.2385507","url":null,"abstract":"","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"111"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Rectus Disabling and Simultaneous Modified Nishida Procedure for Exotropic Duane Retraction Syndrome.","authors":"Karthikeyan Arcot Sadagopan, Nithya Raghunandan, Neha Satish Saswade, Burton J Kushner","doi":"10.1080/2576117X.2024.2375666","DOIUrl":"10.1080/2576117X.2024.2375666","url":null,"abstract":"<p><p>Exotropic-Duane Syndrome (XT-DRS) is a congenital cranial nerve dysinnervation disorder characterized by exotropia, anomalous head posture (contralateral face turn), limited adduction, globe retraction, palpebral fissure narrowing, upshoot and downshoot in adduction, and varying levels of limitation of abduction. Patients with XT-DRS often have poor convergence because attempted convergence induces co-contraction of the lateral rectus muscle (LR) due to anomalous LR innervation. We describe two patients with XT-DRS who underwent simultaneous lateral rectus muscle (LR) disinsertion and periosteal fixation (LRDAPF) and modified Nishida procedure (MNP) and discuss their outcome. In one patient, we combined this procedure with a contralateral LR recession. Anomalous head posture, exotropia, globe retraction, and palpebral fissure narrowing were reduced. Upshoot and downshoot were also reduced. Convergence improved in both patients.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent Exotropia: The Effect of Alternating Occlusion Therapy on Control of Strabismus.","authors":"Martin Boersma","doi":"10.1080/2576117X.2024.2340213","DOIUrl":"10.1080/2576117X.2024.2340213","url":null,"abstract":"<p><strong>Background: </strong>Intermittent exotropia is a common form of pediatric strabismus characterized by intermittent misalignment of the eyes. This study investigated the clinical effectiveness of alternating occlusion therapy as a non-surgical alternative for children aged 3-10 with intermittent exotropia.</p><p><strong>Methods: </strong>A comprehensive review of recent research, including randomized controlled trials and case series, was conducted. These studies utilized standardized control scores to assess the impact of alternating occlusion therapy on both distance and near control of alignment.</p><p><strong>Results: </strong>The findings indicated a significant improvement in exotropia control, particularly at distance fixation, among children undergoing alternating occlusion therapy. While some variability in outcomes exists, all articles demonstrate positive responses to this noninvasive approach. Notably, the patients with poor initial control tended to benefit the most.</p><p><strong>Discussion: </strong>The potential advantages of alternating occlusion therapy are its cost-effectiveness and noninvasive nature. However, it is essential to manage patient and parental expectations and address potential drawbacks, including social stress, irritation associated with occlusion therapy and the possibility that strabismus surgery may still be needed in the future because of decompensation.</p><p><strong>Conclusion: </strong>Alternating occlusion therapy is a promising option to improve exotropia control in children with intermittent exotropia. It offers a viable non-surgical strategy to delay or potentially avoid strabismus surgery, although approximately 45% of the patients might eventually still require strabismus surgery. Healthcare providers should carefully weigh the benefits and limitations of this intervention to make informed decisions through shared decision-making with the patients and their families. This review offers diverse insights into the clinical management of intermittent exotropia and provides an evidence-based alternative to surgical interventions.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"78-83"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior Rectus Muscle Y-Split for Thyroid-Related Vertical Strabismus.","authors":"Yoon H Lee, Stacy L Pineles, Pimpiroon Ploysangam, Federico G Velez","doi":"10.1080/2576117X.2024.2334968","DOIUrl":"10.1080/2576117X.2024.2334968","url":null,"abstract":"<p><p>Incomitant hypotropia in thyroid eye disease can be difficult to manage, especially in the presence of orthotropia with fusion in down gaze and reading position. Recessing the affected ipsilateral inferior rectus muscle may result in an undesirable downgaze diplopia secondary to a hypertropia in downgaze. Various surgical techniques have been described to manage this potential complication including asymmetric recession of both inferior rectus muscles, posterior myoscleropexy operation, and the Scott recess/resect procedure of the contralateral inferior rectus. In 2004, Hoerantner et al. introduced the y-split recession of the medial rectus muscle for near esotropic deviations. The anterior portion of muscle is split and secured in a y-shaped configuration, which reduces the muscle lever arm and helps minimize incomitance and muscle slippage. Unlike the traditional Cüppers Faden, a y-split recession results in torque reduction in all gaze positions. In addition, a y-split recession does not involve scleral passes posteriorly reducing the risk of globe perforation. We report a patient with incomitant strabismus secondary to thyroid eye disease who underwent a combination of traditional recession and y-splitting recession of the contralateral inferior rectus muscle, resulting in good functional alignment in primary gaze and in the reading position.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks and Complications Discussed in Consent for Strabismus Surgery.","authors":"Carolyn May, Evan Silverstein","doi":"10.1080/2576117X.2024.2352176","DOIUrl":"10.1080/2576117X.2024.2352176","url":null,"abstract":"<p><p>This study is a qualitative analysis of the consent process for strabismus surgery, using recordings of physicians doing a mock consent for bilateral medial rectus recession. There is considerable variation in the risks of surgery and odds of complications that are cited by pediatric ophthalmologists during the consent process. We propose a reference table with complication rates for use during the consent process.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Protocol for Accommodative and Vergence Anomalies - A Review.","authors":"Mousumi Saikia, Kamal Pant, Joydeep Dutta","doi":"10.1080/2576117X.2024.2347663","DOIUrl":"10.1080/2576117X.2024.2347663","url":null,"abstract":"<p><strong>Purpose: </strong>To review the diagnostic protocols of non-strabismic binocular vision anomalies.</p><p><strong>Methods: </strong>We carried out a literature search on published articles of non-strabismic accommodative and vergence anomalies in different international optometry and ophthalmology journals found in the Pubmed, ResearchGate, Google Scholar, and MEDLINE databases.</p><p><strong>Results: </strong>The diagnostic criteria and normative data from the nine articles selected show discrepancies and variability in methodologies and techniques in the overall assessment of Non-Strabismic Binocular Vision Anomalies (NSBVA). Near point of convergence measurement is the most common assessment, whereas the vergence facility is the least commonly used assessment in terms of evaluating convergence insufficiency. Near point of convergence > 10 cm alone is the most sensitive sign to detect convergence insufficiency in a community set-up but high positive relative accommodation (>3.50D) is the most sensitive sign to diagnose accommodative excess. On the other hand, monocular accommodative facility < 7 CPM has the highest sensitivity to confirm the diagnosis of accommodative infacility. This review also indicates that the more clinical signs that are included in a set of diagnostic criteria, the lower the prevalence rate for that diagnosis.</p><p><strong>Conclusions: </strong>There is no standardized and diagnostically validated protocol for the assessment of NSBVAs. Variable cutoff values obtained using different methods and the selection of diagnostic criteria by various researchers have led to discrepancies that highlight the need for diagnostic validity of available protocols (combination of tests) for each anomaly. Clinical signs such as positive relative accommodation (PRA) for accommodative excess, near point of convergence (NPC) for convergence insufficiency and monocular accommodative facility (MAF) for accommodative infacility were found to be useful diagnostic signs of these anomalies. Studies should be carried out for accommodative and vergence dysfunctions using proper designs and methods to validate diagnostic criteria for all age groups. Standardization of assessment protocol and cutoff criteria will also aid in calculating prevalence for non-strabismic binocular vision anomalies.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"48-64"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms for Positive Bielschowsky Head Tilt Testing in Horizontal Strabismus.","authors":"Ayman M Elghonemy, Fadia S Attia, Michael C Brodsky","doi":"10.1080/2576117X.2024.2325919","DOIUrl":"10.1080/2576117X.2024.2325919","url":null,"abstract":"<p><strong>Purpose: </strong>To elucidate the induced effects of horizontal strabismus on the Bielschowsky Head Tilt Test (BHTT).</p><p><strong>Design: </strong>Prospective clinical study.</p><p><strong>Methods: </strong>Prospective analysis of BHTT testing in 85 patients with exotropia and 71 patients with esotropia who were examined in a strabismus clinic.</p><p><strong>Results: </strong>Eighty-four of 85 patients with exotropia (98.82%) showed a positive BHTT with an induced hyperdeviation on the side of the tilt (to both sides in 67% and to one side in 32%). Fifty-seven of 71 patients with esotropia (80.2%) showed a positive BHTT with an induced hypodeviation on the side of the tilt (to both sides in 57.7% and to one side in 22.5%). These induced vertical deviations were greater in patients with larger horizontal deviations and in those with constant rather than intermittent deviations; however, they were not influenced by the presence or absence of associated primary oblique muscle overaction.</p><p><strong>Conclusions: </strong>Exotropia and esotropia produce hyperdeviations during BHTT testing, with a hyperdeviation on the side of the tilt observed in patients with exotropia, and hypotropia on the side of the tilt observed in patients with esotropia. These diametrical results are not attributable to any preexistent alteration of neurologic output inherent to these two forms of horizontal strabismus or to associated torsion. Rather, they arise directly from the altered anatomical positions of the two eyes, which cause the eyes to approximate their visual axes more closely to the vertical rectus muscles (in exotropia) and the oblique muscles (in esotropia), enabling the vertical actions of specific cyclovertical muscles to predominate in response to altered utricular output generated by the BHTT.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Trends of Strabismus Surgeries at a Tertiary Hospital Over 2 Decades - What Can Be Learned for Years to Come?","authors":"Asaf Israeli, Tom Bar-Asher, Eedy Mezer","doi":"10.1080/2576117X.2024.2364946","DOIUrl":"10.1080/2576117X.2024.2364946","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze characteristics and trends of strabismus surgeries in an Israeli hospital over 2 decades.</p><p><strong>Methods: </strong>A descriptive, retrospective study including all strabismus surgeries (666) performed during 2000-2019 at an Israeli tertiary hospital. Electronic medical records (EMRs) were directly retrieved to produce an anonymized database.</p><p><strong>Results: </strong>No trends were evident for age, sex, or ethnicity (<i>p</i> = .294, 0.914 and <i>p</i> = .167, respectively). The mean number of horizontal muscles remained stable, while an increase was noted in the mean number of muscles operated on to repair vertical strabismus (<i>p</i> < .0001). Among acquired cases, a 2.67-fold increase was noted in the proportion of spontaneous strabismus and a decrease of traumatic causes to a third (<i>p</i> < .001). An increase was noted in the proportion of exotropia among horizontal strabismus corrections (<i>p</i> = .022), and esotropia correction techniques distribution changed (<i>p</i> = .004). Reoperations comprised a third of all cases during both decades (<i>p</i> = .198). Reoperations were more prevalent among younger and Jewish patients (<i>p</i> < .001 and <i>p</i> = .024, respectively). Techniques to correct esotropia and exotropia differed significantly between primary surgeries and reoperations (<i>p</i> < .00001 each).</p><p><strong>Conclusions: </strong>The complexity of surgical techniques increased over time. Ethnic minorities were less prone to reoperations.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"84-90"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study Assessing the Effect of Exam Room Length on the Measurement of Strabismus.","authors":"Michael Langue, Thomas Kellner, Qian Yang, Erik B Lehman, Ajay Soni","doi":"10.1080/2576117X.2024.2352904","DOIUrl":"10.1080/2576117X.2024.2352904","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aims to investigate the effect of decreasing distance from the patient to the fixation target on the measurement of strabismus with a known distance-near disparity.</p><p><strong>Methods: </strong>Strabismus measurements were taken by one pediatric ophthalmologist at our standard distance of 18 feet and compared to those taken at 16, 14, 12, and 10 feet from the fixation target. A clinically meaningful difference was defined as >2.5 prism diopters (PD), since a difference of that magnitude may alter surgical planning.</p><p><strong>Results: </strong>Thirty-nine subjects, including 22 exotropes and 17 esotropes, were included in this study. Mean prism diopter difference (PDD) in the exotrope group at lengths of 16, 14, 12, and 10 feet compared to 18 feet were 1.3 (SD 1.9, range 0-6), 1.3 (SD 2.2, range 0-8), 1.7 (SD 3.2, range 0-14), and 2.8 (SD 4.4, range 0-14), respectively. Among esotropes, the mean PDD at the same distances were 1.1 (SD 1.9, range 0-7), 2.1 (SD 2.6, range 0-7), 3.9 (SD 4.9, range 0-19), and 4.3 (SD 5.1, range 0-19). The percentages of exotropes with a PDD of >2.5 at 16, 14, 12, and 10 feet compared to 18 feet were 13.6% (<i>n</i> = 3), 13.6% (<i>n</i> = 3), 18.2% (<i>n</i> = 4), and 27.3% (<i>n</i> = 6), respectively. In the esotrope group, 11.8% (<i>n</i> = 2), 35.3% (<i>n</i> = 6), 47.1% (<i>n</i> = 8), and 47.1% (<i>n</i> = 8) had a PDD of >2.5 at the same distances, respectively.</p><p><strong>Conclusion: </strong>This pilot study is the first to investigate the change in measured angle of strabismus at various non-mirrored distances from the patient to the fixation target. Our methodology defines a framework that could be used in a higher-powered study to further our understanding of the effect of room length on strabismus evaluation.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}