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American Orthoptic Journal

Cheryl McCarus
No abstract text is available yet for this article.
2015: American Orthoptic Journal
Gill Roper-Hall
No abstract text is available yet for this article.
2015: American Orthoptic Journal
Joseph Y Shin, Birgit Wahl, Neil R Miller, Eric L Singman
The authors present three patients with idiopathic exercise-induced esotropia. The history, physical findings, and testing that led to the diagnosis are discussed. To the authors' knowledge, this is the largest series of patients with this rare condition, with this series representing half of reported patients in the literature. It is hoped that a discussion of common features of the condition will guide further exploration of the etiology.
2015: American Orthoptic Journal
Suzanne W van Landingham, Eric L Singman
We report a patient who suffered consecutive cranial neuropathies where each event was immediately preceded by the use of oral PDE-5 inhibitors. A discussion of the etiology of the events including possible interaction with other medications is included.
2015: American Orthoptic Journal
Patricia F Jenkins
INTRODUCTION AND PURPOSE: This paper reviews the complaints and associated symptoms/consequences of lacking essential nutrients and vitamins in our central and peripheral nervous systems. This has become important as there has been a rise in malnutrition following the increasing incidence of bariatric surgery for obesity. METHODS: A case report example involving review of the clinical presentation and treatment. RESULTS: A 30-year-old Caucasian woman who had gastric sleeve surgery did not take the recommended capsules as they were too large to swallow...
2015: American Orthoptic Journal
Lindsay A Horan, Benjamin H Ticho, Alexander J Khammar, Megan S Allen, Birva A Shah
BACKGROUND AND PURPOSE: The Convergence Insufficiency Symptom Survey (CISS) is a questionnaire used as an outcome measure in treatment of convergence insufficiency. The current prospective randomized trial evaluates the diagnostic specificity of the CISS. PATIENTS AND METHODS: Surveys were completed by 118 adolescent patients who presented for routine eye examinations. Scores were compared between patients who could be classified as having convergence insufficiency (CI) or normal binocular vision (NBV)...
2015: American Orthoptic Journal
Eric L Singman, Noelle S Matta, Jing Tian, David I Silbert
INTRODUCTION: There is little data validating most illiterate eye charts. Lea Symbols®, however, have been well validated in numerous studies. In this study, we compare the assessment of visual acuity employing both the Lea Symbol hanging wall Early Treatment Diabetic Retinopathy Study (ETDRS)-style chart and a similar Patti Pics® ETDRS-style chart in order to determine whether the two charts provide clinically similar data. METHODS: We tested the vision of the right eyes of fifty-two consecutive patients...
2015: American Orthoptic Journal
Monica L Bratton, Mary Ellen Hoehn, Brannon Morris, Thomas E Merchant, Amar Gajjar, Rutviben Patel, Natalie C Kerr
BACKGROUND: Children with brain neoplasms often develop cranial nerve palsies (CNP) affecting ocular ductions. Duction deficits may improve or resolve with treatment of their intracranial disease. However, these children may be left with residual strabismus. METHODS: We identified 104 children with third, fourth, and/or sixth cranial nerve palsies who were treated for central nervous system (CNS) neoplasms. A retrospective chart review was conducted to determine the presence or absence of residual strabismus following resolution of duction deficits...
2015: American Orthoptic Journal
Kyle Arnoldi, James D Reynolds
PURPOSE: Thyroid eye disease (TED) frequently causes strabismus and diplopia. Though the condition involves multiple extraocular muscles in both eyes, the inferior rectus (IR) muscle is particularly susceptible. TED may be so asymmetric as to mask the involvement of the contralateral IR. The purpose of this study was to determine if the degree of preoperative cyclotropia measured with an objective test could be used to predict the extent of bilateral IR disease and assist in surgical planning...
2015: American Orthoptic Journal
Burton J Kushner
BACKGROUND AND PURPOSE: When patients with intermittent exotropia show an increase in their near deviation after prolonged monocular occlusion, they have been said to have tenacious proximal fusion (TPF). That term is not adequately descriptive, since this finding can occur without the patient having been allowed to fuse. The purpose of this study is to investigate the possibility that this phenomenon is mediated by the preponderance of binasal retinal disparity and uncrossed localization that occurs with near fixation...
2015: American Orthoptic Journal
Misae Ito, Kimiya Shimizu, Tomoya Handa, Hitoshi Ishikawa, Takahiro Niida
INTRODUCTION AND PURPOSE: To investigate the relationship between sensory dominance and ocular deviations. PATIENTS AND METHODS: Sixty-three patients were evaluated with a new device for the measurement of exclusive visibility during binocular rivalry. The patients were consisted of twenty-three with exotropia (XT), twenty with intermittent exotropia [X(T)], twenty with exophoria (XP), respectively. Device is composed of two retinometers, their holders in which angle and position can be adjustable and a PC for data storage and analysis...
2015: American Orthoptic Journal
Darren Oystreck
Concepts regarding certain forms of congenital eye movement disorders have recently changed, due in large part to new genetic evidence identifying causative genes and their role in the development of extraocular muscle innervation. This group is now referred to as the Congenital Cranial Dysinnervation Disorders (CCDDs). Careful assessment of phenotypic features that include both ophthalmological and non-ophthalmological features in genetically defined individuals has led to the development of a more robust classification system...
2015: American Orthoptic Journal
Alex Christoff
BACKGROUND AND PURPOSE: Certified orthoptists are routinely required, as a standard component of outpatient care, to examine and identify the cause of double vision described by neuro-ophthalmology and oculo-plastics patients. Peer-reviewed articles in the strabismus literature describing the significance of this role of the orthoptists, especially in more complex cases of strabismus, do exist, but are outdated. The importance of creating a differential diagnosis in the understanding of the disease process is a well-recognized component of medical education and modern medicine...
2015: American Orthoptic Journal
Rikki Gilligan
Patients with motility problems due to neurodegenerative disease such as Parkinson's and its variations often present challenging cases for the orthoptist. A few "tricks of the trade" will be presented on how to make a Parkinson's patient's daily life a little easier.
2015: American Orthoptic Journal
Terra Haller
An esodeviation that is greater at distance than near in an adult patient requires a full sensorimotor exam to rule out any cofounding neurological conditions. Many etiologies are described in the literature to cause an esodeviation that is greater at distance than near in adult patients and some exist in conjunction with a neurological condition. However, many adult patients present to the adult strabismus clinic with no other findings on exam and have a purely benign divergence insufficiency esotropia. A review of the literature on divergence insufficiency reveals a few attempts of classifying these entities, but none have been completely accepted...
2015: American Orthoptic Journal
Stacy L Pineles
Divergence insufficiency esotropia, or acquired comitant esotropia that is at least 10Δ larger at distance than at near, is most often seen in older adults, and may also be known as "age-related distance esotropia." Surgical treatment is often indicated for patients who do not tolerate prism therapy, or for those with large angles of esotropia. Surgical treatments have evolved with our understanding of the disease-state. Currently, accepted treatments include lateral rectus resection and medial rectus recession...
2015: American Orthoptic Journal
Steven M Archer
INTRODUCTION AND PURPOSE: Symptomatic, small-angle strabismus is largely an acquired problem of adults that has previously been managed with prism spectacles. This paper will explore surgical options that are becoming increasingly popular. METHODS: The special issues that confound surgical treatment of small-angle strabismus are considered. Surgical procedures described in the literature and in the author's experience that address these issues are reviewed. RESULTS: Several recently described surgical techniques show promise for treatment of small-angle strabismus in adults...
2015: American Orthoptic Journal
Sara Shippman, Kenneth R Cohen, Larissa Heiser
Maculopathies affect point-to-point foveal correspondence causing diplopia. The effect that the maculopathies have on the interaction of central sensory fusion and peripheral fusion are different than the usual understanding of treatment for diplopia. This paper reviews the pathophysiology of macular diplopia, describes the binocular pathology causing the diplopia, discusses the clinical evaluation, and reviews the present treatments including some newer treatment techniques.
2015: American Orthoptic Journal
Aaron M Miller
BACKGROUND AND PURPOSE: Torsional diplopia can result in failure of fusion in an individual without a measureable strabismus. When presented with a patient with complaints of binocular diplopia, physicians and orthoptists should consider cyclovertical muscle dysfunction when the source of the complaint is not readily apparent. METHODS: A thorough review of the literature combined with the author's own personal experience in treating adult patients with strabismus was used to evaluate the different potential causes of torsional diplopia...
2015: American Orthoptic Journal
Aaron M Miller
BACKGROUND AND PURPOSE: The profession of orthoptics has been present for over 100 years and was created as a partnership with pediatric ophthalmology in an effort to provide better strabismus care to children. Orthoptists are known to improve practice efficiency, but to date, no quantitative data has been presented in the literature to support this claim. Proper utilization of an orthoptist is critical to improving practice efficiency and revenue. METHODS: Over a 6-month period, the financial impact to a pediatric ophthalmology practice by the addition of a second certified orthoptist (C...
2015: American Orthoptic Journal
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