Journal of Binocular Vision and Ocular Motility最新文献

For patients with a complete, chronic abducens nerve palsy and resulting abduction deficit, a transposition procedure is often the procedure of choice. One such transposition procedure involves transposing the superior rectus (SR) and inferior rectus (IR) laterally without disinserting or splitting either muscle. While effective, this procedure - like many transposition procedures - carries with it the risk of induced torsional or vertical misalignment. Here, we describe an adjustable variation of the above transposition procedure, one which potentially would allow for post-operative correction of induced vertical or torsional deviations.

Purpose: To determine practice patterns of pediatric ophthalmologists with respect to types of medical conditions cared for and age of patients treated due to limited data regarding pediatric ophthalmologists' scope of practice.

Methods: A survey was sent to 1408 international and United States members of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) membership through the group's internet listserv. Responses were collated and analyzed.

Results: Ninety members (6.4%) responded. 89% of respondents confine their practices to pediatric ophthalmology and adult strabismus. The percentages of respondents who provide primary surgical and medical treatment of the following conditions include 68% for ptosis and anterior orbital lesions, 49% for cataracts, 38% for uveitis, 25% for retinopathy of prematurity, 19% for glaucoma, and 7% for retinoblastoma. For conditions other than strabismus, 59% restrict their practice to patients less than 21 years of age.

Conclusion: Pediatric ophthalmologists provide primary medical and surgical care for children with a wide variety of ocular conditions, including complex disorders. Awareness of this variety of practice might prove beneficial in encouraging residents to consider careers in pediatric ophthalmology. Consequently, fellowship education in pediatric ophthalmology should include exposure to these areas.

Purpose: To quantify typical disease characteristics for patients with congenital fibrosis of the extraocular muscles (CFEOM) including pre-and post-surgical ocular alignment and head positioning as well as average improvement with surgical intervention.

Patients and methods: This investigation is a systematic review and meta-analysis. All studies detailing surgical intervention in cohorts of individuals with CFEOM were included. Ocular alignment and head positioning before and after surgery was recorded. Meta-analyses were performed to quantify these findings along with other patient characteristics across all included studies.

Results: The estimated average improvement in vertical alignment for patients with unilateral and bilateral CFEOM was 34.8 pd (prism diopters) and 21.27 pd, respectively. For horizontal alignment, patients with unilateral and bilateral CFEOM improved an average of 25.39 pd and 10.99 pd after surgery, respectively. There was no significant difference between the two most common surgeries used to address hypotropia and blepharoptosis in this patient population. The estimated proportion of patients with post-surgical head alignment within 5-9° was 60.64% and was 28.25% for patients with<5° of alignment.

Conclusion: This study was able to illuminate many characteristic features of patients with CFEOM. Surgical intervention for the ocular alignment and head positioning of these patients demonstrates promising utility.

Amblyopia is characterized by spatiotemporal uncertainty in the visual system. In addition to its effects on vision, amblyopia also exerts a widespread impact on other systems. Many of these changes are observed not only during amblyopic eye viewing but also during fellow eye and binocular viewing. They generally correlate with the severity of visual acuity and stereo acuity loss. The affected systems include: (1) oculomotor control manifested as abnormal fixation, saccades, smooth pursuit, and saccadic adaptation; (2) motor control with altered programming, execution, and temporal dynamics of eye-hand coordination, and decreased ability of the sensorimotor system to adapt to changes in the visual environment; (3) balance control with decreased postural stability; (4) multisensory integration characterized by reduced McGurk effect and altered cross-modal interactions in audiovisual perception; and (5) auditory localization manifested as impaired spatial hearing as a result of abnormal developmental calibration of the auditory map. To detect amblyopia early, a targeted approach is required to identify children from low-income families through in-school visual screening, supplemented by follow-up care and free eyeglasses in high-needs schools.

Purpose: To ascertain the use of screen tests for assessing strabismus under binocular viewing conditions by certified orthoptist colleagues around the United States of America.

Methods: A link to an online survey was distributed to all 440 registered members of the American Association of Certified Orthoptists in early 2022. A total of 135 certified orthoptists responded.

Results: Of the 135 respondents, 51% were from a public practice, 36% were private practice and 13% from a mixture of both. A large proportion of respondents did not use binocular screen tests to measure strabismus such as the Lancaster red/green test (85%) or Hess screen test (93%), although one respondent reported using the Harms screen test. Most respondents reported using single or double Maddox rods (75%), synoptophore (44%) and prisms (14%) in their practice to quantify strabismus clinically.

Conclusion: There is limited use of screen tests in private and public practice in the USA. The ergonomic requirements of such tests are prohibitive to their implementation in modern clinical practice.