Pub Date : 2011-12-01DOI: 10.1016/j.optm.2010.11.016
Ann M. Van Wie O.D.
Background
Hepatitis C is a common virus affecting approximately 170 million people worldwide. The main ocular manifestations of hepatitis C virus include a Sjögren-type of dry eye syndrome and an ischemic retinopathy secondary to treatment with interferon or a result of a systemic vasculitis induced by the infection itself. Current treatment for hepatitis C is a combination therapy using pegylated (long-lasting) interferon and ribavirin. This treatment, however, is not without ocular sequelae. Interferon-associated retinopathy is present in > 50% of patients taking the drug and is mainly characterized by cotton wool spots and retinal hemorrhages. The pathogenesis of this disorder is not specifically known. Fortunately, many patients remain asymptomatic, and the retinal changes are usually reversible.
Case Report
A 48-year-old black man presented to the clinic complaining of decreased vision in both eyes for the previous few weeks. His medical history was positive for hypertension and hepatitis C for which he was being treated. At his examination, he had interferon retinopathy diagnosed. Soon thereafter, his treatment for hepatitis C was discontinued, and when he returned for follow-up 4 months later, his retinal findings had resolved.
Conclusions
An overview of hepatitis C and its recommended therapy and possible ocular side effects are reviewed, as well as the differential diagnosis of interferon-associated retinopathy, 1 of the main side effects of treatment.
{"title":"Hepatitis C and interferon-associated retinopathy: A case report","authors":"Ann M. Van Wie O.D.","doi":"10.1016/j.optm.2010.11.016","DOIUrl":"10.1016/j.optm.2010.11.016","url":null,"abstract":"<div><h3>Background</h3><p><span><span><span><span>Hepatitis C is a common virus affecting approximately 170 million people worldwide. The main ocular manifestations of </span>hepatitis C virus include a Sjögren-type of dry eye syndrome and an ischemic </span>retinopathy<span> secondary to treatment with </span></span>interferon<span> or a result of a systemic vasculitis induced by the infection itself. Current treatment for hepatitis C is a combination therapy using pegylated (long-lasting) interferon and </span></span>ribavirin<span><span>. This treatment, however, is not without ocular sequelae. Interferon-associated retinopathy is present in > 50% of patients taking the </span>drug<span><span> and is mainly characterized by cotton wool spots and </span>retinal hemorrhages. The pathogenesis of this disorder is not specifically known. Fortunately, many patients remain asymptomatic, and the retinal changes are usually reversible.</span></span></p></div><div><h3>Case Report</h3><p>A 48-year-old black man presented to the clinic complaining of decreased vision in both eyes for the previous few weeks. His medical history was positive for hypertension and hepatitis C for which he was being treated. At his examination, he had interferon retinopathy diagnosed. Soon thereafter, his treatment for hepatitis C was discontinued, and when he returned for follow-up 4 months later, his retinal findings had resolved.</p></div><div><h3>Conclusions</h3><p>An overview of hepatitis C and its recommended therapy and possible ocular side effects are reviewed, as well as the differential diagnosis of interferon-associated retinopathy, 1 of the main side effects of treatment.</p></div>","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2010.11.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30276099","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}
Pub Date : 2011-12-01DOI: 10.1016/S1529-1839(11)00555-0
{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S1529-1839(11)00555-0","DOIUrl":"https://doi.org/10.1016/S1529-1839(11)00555-0","url":null,"abstract":"","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1529-1839(11)00555-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136843140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-01DOI: 10.1016/j.optm.2011.06.011
David P. Roncone O.D.
Background
Keratoectasia is a rare but well-known complication after laser-assisted in situ keratomileusis (LASIK). Patients with this condition can have high and irregular astigmatism. When the treatment of the high astigmatic correction cannot be accomplished surgically or when the keratoectasia patient rejects surgical enhancement, optical correction with devices such as soft or rigid gas-permeable contact lenses may be pursued. In fact, toric soft contact lenses are a good first option for fitting postoperative keratoectasia patients.
Case report
A 58-year-old white male presented for an examination with a complaint of decreased distance vision in the right eye (OD) after having traditional LASIK for myopia with astigmatism in both eyes (OU) in 1999 and limbal relaxing incision enhancement OD in 2003. Refraction showed high mixed astigmatism OD (+1.75 -5.75×075). Slit lamp examination found irregularity of the cornea, evidenced by an inferior cone with pigmented Fleischer ring OD. Video keratometry had keratometry readings of 43.50 at 160, 39.87 at 070, elevated shape measure (0.40), elevated corneal irregularity measure (3.96), an inferior cone on the elevation map, and asymmetric bowtie with elongation inferonasally on the axial map, which confirmed the diagnosis of postoperative keratoectasia. Because new surgical treatments at that time for corneal ectasia were in their infancy and not approved by the U.S. Food and Drug Administration, the patient opted for a trial toric soft contact lens fitting, which improved his corrected distance visual acuity to 20/25.
Conclusion
This case report confirms that toric soft contact lenses are a good first choice in fitting patients with high and irregular astigmatism from postoperative LASIK corneal ectasia. It also confirms that excellent vision and comfort with toric soft contact lenses is possible in these patients.
{"title":"Toric soft contact lens fit in a postoperative LASIK keratoectasia patient with high and irregular astigmatism","authors":"David P. Roncone O.D.","doi":"10.1016/j.optm.2011.06.011","DOIUrl":"10.1016/j.optm.2011.06.011","url":null,"abstract":"<div><h3>Background</h3><p><span>Keratoectasia is a rare but well-known complication after laser-assisted in situ keratomileusis (LASIK). Patients with this condition can have high and irregular astigmatism. When the </span>treatment<span> of the high astigmatic correction cannot be accomplished surgically or when the keratoectasia patient rejects surgical enhancement, optical correction with devices such as soft or rigid gas-permeable contact lenses may be pursued. In fact, toric soft contact lenses are a good first option for fitting postoperative keratoectasia patients.</span></p></div><div><h3>Case report</h3><p><span><span>A 58-year-old white male presented for an examination with a complaint of decreased distance vision in the right eye (OD) after having traditional LASIK for myopia with astigmatism in both eyes (OU) in 1999 and limbal relaxing incision enhancement OD in 2003. Refraction showed high mixed astigmatism OD (+1.75 -5.75×075). </span>Slit lamp examination found irregularity of the cornea, evidenced by an inferior cone with pigmented Fleischer ring OD. Video </span>keratometry<span> had keratometry readings of 43.50 at 160, 39.87 at 070, elevated shape measure (0.40), elevated corneal irregularity measure (3.96), an inferior cone on the elevation map, and asymmetric bowtie with elongation inferonasally on the axial map, which confirmed the diagnosis of postoperative keratoectasia. Because new surgical treatments at that time for corneal ectasia<span> were in their infancy and not approved by the U.S. Food and Drug Administration, the patient opted for a trial toric soft contact lens fitting, which improved his corrected distance visual acuity to 20/25.</span></span></p></div><div><h3>Conclusion</h3><p>This case report confirms that toric soft contact lenses are a good first choice in fitting patients with high and irregular astigmatism from postoperative LASIK corneal ectasia. It also confirms that excellent vision and comfort with toric soft contact lenses is possible in these patients.</p></div>","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2011.06.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30081841","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}
Pub Date : 2011-12-01DOI: 10.1016/j.optm.2011.10.009
Leonard J. Press O.D.
{"title":"Vision Rehabilitation: Multidisciplinary Care of the Patient Following Brain Injury","authors":"Leonard J. Press O.D.","doi":"10.1016/j.optm.2011.10.009","DOIUrl":"10.1016/j.optm.2011.10.009","url":null,"abstract":"","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2011.10.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86099620","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}
Pub Date : 2011-11-03DOI: 10.1016/J.OPTM.2011.05.008
Samantha L C Nogales, A. Grimes, Huey-Fen Song
{"title":"Lipemia retinalis: a combination of genetics and the American diet and lifestyle.","authors":"Samantha L C Nogales, A. Grimes, Huey-Fen Song","doi":"10.1016/J.OPTM.2011.05.008","DOIUrl":"https://doi.org/10.1016/J.OPTM.2011.05.008","url":null,"abstract":"","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81423721","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}
Pub Date : 2011-11-01DOI: 10.1016/j.optm.2011.07.003
Niru K. Nahar Ph.D. , Sowjanya Gowrisankaran Ph.D. , John R. Hayes Ph.D. , James E. Sheedy O.D., Ph.D.
Background
The objective of this research is to assess the ocular and muscular response to long-duration reading under different visual and cognitive difficulty levels.
Methods
Thirty-five subjects, with 20/20 vision and without history of ocular pathology or cognitive deficits, participated in the study. Subjects read under different visual and cognitive difficulty levels for 6 (30-minute) conditions. Upper and lower orbicularis oculi, frontalis, and trapezius muscle activities were recorded using surface electromyography (EMG). Aperture size, pupil diameter, and pulse rate of the subjects were recorded with a video camera, pulse meter, and ISCAN eye tracker (ISCAN Inc.), respectively.
Results
The results show that the texts read with a refractive error caused increased orbicularis oculi EMG power and reduced aperture size (P < 0.001). There was no statistically significant difference between the conditions for pulse rate, pupil diameter, or EMG activity of the frontalis and trapezius muscles with either visual or cognitive stress presented in this experiment.
Conclusion
Visual stress experienced due to reading under an induced refractive error is potentially mediated by a local mechanism, different from the mechanism underlying reading under low contrast or high cognitive demand.
{"title":"Interactions of visual and cognitive stress","authors":"Niru K. Nahar Ph.D. , Sowjanya Gowrisankaran Ph.D. , John R. Hayes Ph.D. , James E. Sheedy O.D., Ph.D.","doi":"10.1016/j.optm.2011.07.003","DOIUrl":"10.1016/j.optm.2011.07.003","url":null,"abstract":"<div><h3>Background</h3><p>The objective of this research is to assess the ocular and muscular response to long-duration reading under different visual and cognitive difficulty levels.</p></div><div><h3>Methods</h3><p><span><span>Thirty-five subjects, with 20/20 vision and without history of ocular pathology or </span>cognitive deficits, participated in the study. Subjects read under different visual and cognitive difficulty levels for 6 (30-minute) conditions. Upper and lower orbicularis oculi, frontalis, and </span>trapezius muscle<span><span> activities were recorded using surface electromyography (EMG). Aperture size, pupil diameter, and pulse rate of the subjects were recorded with a video camera, pulse meter, and ISCAN </span>eye tracker (ISCAN Inc.), respectively.</span></p></div><div><h3>Results</h3><p><span>The results show that the texts read with a refractive error caused increased orbicularis oculi EMG power and reduced aperture size (</span><em>P</em> < 0.001). There was no statistically significant difference between the conditions for pulse rate, pupil diameter, or EMG activity of the frontalis and trapezius muscles with either visual or cognitive stress presented in this experiment.</p></div><div><h3>Conclusion</h3><p>Visual stress experienced due to reading under an induced refractive error is potentially mediated by a local mechanism, different from the mechanism underlying reading under low contrast or high cognitive demand.</p></div>","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2011.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30115783","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}
Pub Date : 2011-11-01DOI: 10.1016/j.optm.2011.08.008
Stuart P. Richer O.D., Ph.D. , William Stiles M.D., J.D. , Kelly Graham-Hoffman PsyD , Marc Levin M.D., J.D. , Dennis Ruskin O.D. , James Wrobel DPM , Dong-Wouk Park , Carla Thomas
Background
The purpose of this study is to evaluate whether dietary supplementation with the carotenoid zeaxanthin (Zx) raises macula pigment optical density (MPOD) and has unique visual benefits for patients with early atrophic macular degeneration having visual symptoms but lower-risk National Institute of Health/National Eye Institute/Age-Related Eye Disease Study characteristics.
Methods
This was a 1-year, n = 60 (57 men, 3 women), 4-visit, intention-to-treat, prospective, randomized controlled clinical trial of patients (74.9 years, standard deviation [SD] 10) with mild-to-moderate age-related macular degeneration (AMD) randomly assigned to 1 of 2 dietary supplement carotenoid pigment intervention groups: 8 mg Zx (n = 25) and 8 mg Zx plus 9 mg lutein (L) (n = 25) or 9 mg L (“Faux Placebo,” control group, n = 10). Analysis was by Bartlett’s test for equal variance, 3-way repeated factors analysis of variance, independent t test (P < 0.05) for variance and between/within group differences, and post-hoc Scheffé's tests. Estimated foveal heterochromic flicker photometry, 1° macular pigment optical density (MPOD QuantifEye®), low- and high-contrast visual acuity, foveal shape discrimination (Retina Foundation of the Southwest), 10° yellow kinetic visual fields (KVF), glare recovery, contrast sensitivity function (CSF), and 6° blue cone ChromaTest® color thresholds were obtained serially at 4, 8, and 12 months.
Results
Ninety percent of subjects completed ≥ 2 visits with an initial Age-Related Eye Disease Study report #18 retinopathy score of 1.4 (1.0 SD)/4.0 and pill intake compliance of 96% with no adverse effects. There were no intergroup differences in 3 major AMD risk factors: age, smoking, and body mass index as well as disease duration and Visual Function Questionnaire 25 composite score differences. Randomization resulted in equal MPOD variance and MPOD increasing in each of the 3 groups from 0.33 density units (du) (0.17 SD) baseline to 0.51 du (0.18 SD) at 12 m, (P = 0.03), but no between-group differences (Analysis of Variance; P = 0.47). In the Zx group, detailed high-contrast visual acuity improved by 1.5 lines, Retina Foundation of the Southwest shape discrimination sharpened from 0.97 to 0.57 (P = 0.06, 1-tail), and a larger percentage of Zx patients experienced clearing of their KVF central scotomas (P = 0.057). The “Faux Placebo” L group was superior in terms of low-contrast visual acuity, CSF, and glare recovery, whereas Zx showed a trend toward significance.
Conclusion
In older male patients with AMD, Zx-induced foveal MPOD elevation mirrored that of L and provided compl
{"title":"Randomized, double-blind, placebo-controlled study of zeaxanthin and visual function in patients with atrophic age-related macular degeneration","authors":"Stuart P. Richer O.D., Ph.D. , William Stiles M.D., J.D. , Kelly Graham-Hoffman PsyD , Marc Levin M.D., J.D. , Dennis Ruskin O.D. , James Wrobel DPM , Dong-Wouk Park , Carla Thomas","doi":"10.1016/j.optm.2011.08.008","DOIUrl":"10.1016/j.optm.2011.08.008","url":null,"abstract":"<div><h3>Background</h3><p>The purpose of this study is to evaluate whether dietary supplementation<span> with the carotenoid<span> zeaxanthin<span> (Zx) raises macula pigment optical density<span> (MPOD) and has unique visual benefits for patients with early atrophic macular degeneration having visual symptoms but lower-risk National Institute of Health/National Eye Institute/Age-Related Eye Disease Study characteristics.</span></span></span></span></p></div><div><h3>Methods</h3><p><span><span>This was a 1-year, n = 60 (57 men, 3 women), 4-visit, intention-to-treat, prospective, randomized controlled clinical trial of patients (74.9 years, standard deviation [SD] 10) with mild-to-moderate age-related macular degeneration (AMD) randomly assigned to 1 of 2 dietary supplement carotenoid pigment intervention groups: 8 mg Zx (n = 25) and 8 mg Zx plus 9 mg </span>lutein<span> (L) (n = 25) or 9 mg L (“Faux Placebo,” control group, n = 10). Analysis was by Bartlett’s test for equal variance, 3-way repeated factors analysis of variance, independent </span></span><em>t</em> test (<em>P</em><span><span> < 0.05) for variance and between/within group differences, and post-hoc Scheffé's tests. Estimated foveal heterochromic flicker photometry, 1° </span>macular pigment optical density (MPOD QuantifEye</span><sup>®</sup><span><span>), low- and high-contrast visual acuity, foveal shape discrimination (Retina Foundation of the Southwest), 10° yellow kinetic visual fields (KVF), glare recovery, </span>contrast sensitivity function (CSF), and 6° blue cone ChromaTest</span><sup>®</sup> color thresholds were obtained serially at 4, 8, and 12 months.</p></div><div><h3>Results</h3><p><span><span>Ninety percent of subjects completed ≥ 2 visits with an initial Age-Related Eye Disease Study report #18 retinopathy score of 1.4 (1.0 SD)/4.0 and pill intake compliance of 96% with no adverse effects. There were no intergroup differences in 3 major AMD risk factors: age, smoking, and </span>body mass index<span> as well as disease duration and Visual Function Questionnaire 25 composite score differences. Randomization resulted in equal MPOD variance and MPOD increasing in each of the 3 groups from 0.33 density units (du) (0.17 SD) baseline to 0.51 du (0.18 SD) at 12 m, (</span></span><em>P</em> = 0.03), but no between-group differences (Analysis of Variance; <em>P</em> = 0.47). In the Zx group, detailed high-contrast visual acuity improved by 1.5 lines, Retina Foundation of the Southwest shape discrimination sharpened from 0.97 to 0.57 (<em>P</em><span> = 0.06, 1-tail), and a larger percentage of Zx patients experienced clearing of their KVF central scotomas (</span><em>P</em> = 0.057). The “Faux Placebo” L group was superior in terms of low-contrast visual acuity, CSF, and glare recovery, whereas Zx showed a trend toward significance.</p></div><div><h3>Conclusion</h3><p>In older male patients with AMD, Zx-induced foveal MPOD elevation mirrored that of L and provided compl","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2011.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30231850","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}
Pub Date : 2011-11-01DOI: 10.1016/j.optm.2011.09.006
Gary Gerber O.D.
{"title":"Updating the practice for the better","authors":"Gary Gerber O.D.","doi":"10.1016/j.optm.2011.09.006","DOIUrl":"10.1016/j.optm.2011.09.006","url":null,"abstract":"","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2011.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78041117","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}
Pub Date : 2011-11-01DOI: 10.1016/j.optm.2011.02.020
Josephine O. Ibironke O.D., MPH
Background
Microtropia is a small-angle strabismus with a highly developed degree of binocular cooperation. It is a unilateral comitant horizontal deviation less than 5 prism diopters (PD) in the presence of anomalous retinal correspondence (ARC), amblyopia, some motor fusion, and reduced stereoacuity.
Case report
A 7-year-old white girl presented for a second opinion concerning unexplained vision loss in the left eye. Visual acuities were 20/20 in the right eye and 20/200 in the left eye. Ocular evaluation found normal eye health with a 4-PD constant left esotropia at near and a 3-PD constant left esotropia at distance on unilateral cover test. A diagnosis of steady nasal eccentric fixation microtropia without identity with strabismic amblyopia in the left eye was made. Over the follow-up period, visual acuity improved but the alignment did not.
Conclusion
Microtropia can defy detection, resulting in a reduced chance of achieving near-normal visual potential in children. It is important for clinicians to understand the possible etiologies, related entities, proper testing, differential diagnoses, and the goals of treatment. This case report reviews the clinical findings, diagnoses, and management of patients with microtropia.
{"title":"Microtropia: clinical findings and management for the primary eye care practitioner","authors":"Josephine O. Ibironke O.D., MPH","doi":"10.1016/j.optm.2011.02.020","DOIUrl":"10.1016/j.optm.2011.02.020","url":null,"abstract":"<div><h3>Background</h3><p>Microtropia is a small-angle strabismus with a highly developed degree of binocular cooperation. It is a unilateral comitant horizontal deviation less than 5 prism diopters (PD) in the presence of anomalous retinal correspondence (ARC), amblyopia, some motor fusion, and reduced stereoacuity.</p></div><div><h3>Case report</h3><p>A 7-year-old white girl presented for a second opinion concerning unexplained vision loss<span><span> in the left eye. Visual acuities were 20/20 in the right eye and 20/200 in the left eye. Ocular evaluation found normal eye health with a 4-PD constant left </span>esotropia at near and a 3-PD constant left esotropia at distance on unilateral cover test. A diagnosis of steady nasal eccentric fixation microtropia without identity with strabismic amblyopia in the left eye was made. Over the follow-up period, visual acuity improved but the alignment did not.</span></p></div><div><h3>Conclusion</h3><p>Microtropia can defy detection, resulting in a reduced chance of achieving near-normal visual potential in children. It is important for clinicians to understand the possible etiologies, related entities, proper testing, differential diagnoses, and the goals of treatment. This case report reviews the clinical findings, diagnoses, and management of patients with microtropia.</p></div>","PeriodicalId":51265,"journal":{"name":"Optometry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.optm.2011.02.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30134084","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}
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