Conjugate horizontal gaze paresis – what tactics to choose

Purpose. To analyze the success of using prisms in conjugate horizontal gaze paresis compared to other treatment methods. Material and methods. The study involved 30 patients with conjugate horizontal gaze paresis. The average age of patients at the time of treatment was 57.8±6.68 years. The average period of clinical follow-up for strabismus symptoms in patients after the appropriate treatment was 12.6±3.8 months. The patients were divided into two groups: the first group (main group) of 15 patients who underwent prismatic correction in combination with etiopathogenetic treatment and 15 patients (control group) who underwent etiopathogenetic treatment without prismatic correction. Results. The treatment results were evaluated according to three criteria: absence of abnormal head posture (AHP) and diplopia, as well as elimination of esotropia. Based on our data, the AHP angle did not reveal statistically significant difference at the stage before treatment (p=0.999), however, during treatment in the first group (using prismatic correction), it was 4.4 times less than in the second group (p<0.001). Similar data were obtained in relation to esotropia. Results of the statistical analysis showed that during treatment, frequency of binocular single vision exposed a statistically significant increase (p<0.05) in both the first and second groups. Conclusion. Thus, for 15 patients with conjugate horizontal gaze paresis, prismatic correction made it possible to create conditions for shifting the image perceived by a patient to a straight field of gaze, as well as to eliminate the occurrence of induced heterotropia and diplopia in the attempt to look straight and, accordingly, the formation of AHP. The proposed method provided an opportunity to reduce complaints and improve the patients' quality of life. Key words: conjugate horizontal gaze paresis, diplopia, abnormal head posture, Fresnel prisms