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Maddox Rod

João Lemos, Adnan Subei, Mário Sousa, César Nunes, Luís Cunha, Christopher Glisson, Eric Eggenberger
Importance: Accurate clinical differentiation between skew deviation and fourth nerve palsy (4NP) is critical in the acute and subacute settings. Objective: To determine the sensitivity and specificity of the upright-supine test to detect vertical misalignment changes using different head positions for the diagnosis of acute or subacute skew deviation vs 4NP. Design, Setting, and Participants: This multicenter study enrolled consecutive patients from Coimbra University Hospital Centre, Coimbra, Portugal, and Michigan State University, Lansing, within 2 months of presenting with vertical diplopia and diagnosed as having skew deviation or acquired unilateral 4NP...
April 1, 2018: JAMA Ophthalmology
Laura Liebermann, David A Leske, Sarah R Hatt, Jonathan M Holmes
The double Maddox rod test is often used to measure cyclodeviations and to monitor change over time. The purpose of this study was to estimate test-retest reliability and the amount of cyclodeviation that would be considered real change using 95% limits of agreement. We retrospectively studied 86 clinically stable patients with double Maddox rod measurements 5-175 days apart (median, 69 days). The range of cyclodeviation at the first measurement was 6° incyclodeviation to 15° excyclodeviation. We calculated the half width of the 95% limits of agreement to be 4...
April 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Y D Kim, H K Yang, J-M Hwang
PurposeThe double Maddox-rod test (DMRT) and Lancaster red-green test (LRGT) are the most widely used tests worldwide to assess subjective ocular torsion. However, these tests require equipment and the quantified results of ocular torsion are only provided in rough values. Here we developed a novel computerized torsion test (CTT) for individual assessment of subjective ocular torsion and validated the reliability and accuracy of the test compared with those of the DMRT and LRGT.MethodsA total of 30 patients with cyclovertical strabismus and 30 controls were recruited...
November 2017: Eye
Bashar M Bata, David A Leske, Jonathan M Holmes
PURPOSE: Bilateral fourth nerve palsy may be symmetric or asymmetric with combined vertical and excylotropic deviations and so there may be an advantage to independent adjustment of vertical and torsional components. We report a surgical technique that allows such independent adjustment. DESIGN: Retrospective interventional case series. METHODS: Fifteen patients, aged 17-73 years, underwent adjustable bilateral superior oblique tendon advancements for bilateral fourth nerve palsy: 11 symmetric (≤2 prism diopters [pd] hyperdeviation in straight-ahead gaze) and 4 asymmetric...
June 2017: American Journal of Ophthalmology
Yair Ivanir, Jonathan D Trobe
BACKGROUND: Isolated fourth nerve palsies are commonly caused by decompensation of a congenitally dysfunctional superior oblique muscle ("decompensated congenital palsies"). Distinguishing such palsies at initial presentation from palsies caused by presumed microvascular ischemia ("ischemic palsies") has value for patient reassurance and in forestalling ancillary testing. Abnormally large vertical fusional amplitudes traditionally have been used to identify decompensated congenital palsies, but that may not be a reliable distinguishing feature...
December 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Jinu Han, Minjae Kang, Sueng-Han Han
We present a case of acquired severe excyclotropia that occurred following multiple orbital wall fracture and traumatic superior oblique palsy in an 18-year-old man. The patient suffered from severe torsional diplopia in the right eye; double Maddox rod testing showed excylotorsion of 25°. After anterior nasal transposition of the right inferior oblique muscle, His subjective torsional diplopia improved; however, severe antielevation syndrome was noted after surgery.
October 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
G E Arblaster, J P Burke
AIM: To describe the surgical management and long-term outcome of a case of symptomatic residual acquired primary position excyclotropia, without changing the primary position vertical deviation. METHODS: This case report describes ipsilateral half tendon width transpositions of the left superior rectus temporally and inferior rectus nasally, combined with right inferior rectus posterior fixation suture at 11 mm. RESULTS: Three days postoperatively, the transposition procedure produced a 10° cyclotorsional change in primary position, resulting in 5° of incyclotorsion (double Maddox rod)...
September 2016: Strabismus
Katarina Ivana Tudor, Damir Petravić, Anđela Jukić, Zlatko Juratovac
OBJECTIVE: To present a patient with a sudden onset ocular tilt reaction (OTR) and review recent knowledge and evolving insights of the underlying pathophysiological mechanisms of skew deviation and OTR. METHODS: A middle-aged hypertensive man who had previously suffered stroke with good recovery presented with sudden-onset double vision, slurred speech, ataxia, and a head tilt. Romberg test was positive. The patient denied having disturbances of visual acuity, eye pain, or recent trauma...
2017: Seminars in Ophthalmology
Sara Flodin, Per Karlsson, Marita Andersson Grönlund
PURPOSE: To establish if cyclotorsion measurements obtained in a patient population using different methods of testing give equivalent results, and if the results from each test are repeatable over time. METHODS: Twenty referrals, from the orthoptic waiting list at Sahlgrenska University Hospital, Mölndal, Sweden, with vertical deviation stated as the primary reason for referral, were examined. Subjective cyclotorsion measurements using three different methods were performed...
2016: Strabismus
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
Tara L Alvarez
PURPOSE: This study examined the relationship between the near dissociated phoria and disparity vergence eye movements. Convergence insufficiency (CI) patients before vergence therapy were compared to: (1) the same patients after vergence therapy; and (2) binocularly normal controls (BNC). METHODS: Sixteen subjects were studied-twelve BNC and four with CI. Measurements from the CI subjects were obtained before and after 18 h of vergence eye movement therapy. The near dissociated phoria was measured using the flashed Maddox rod technique...
2015: Frontiers in Human Neuroscience
Ken Steinegger, Raoul De Haller, Delphine Courvoisier, Paolo Scolozzi
The aim of this study was to prospectively assess the prevalence of orthoptic anomalies following conservative management of pure blowout orbital fractures and to evaluate their clinical relevance. Clinical and radiologic data of patients with unilateral conservatively managed pure blowout orbital fractures with a minimum follow-up of 6 months were reviewed. Eligible patients were contacted and invited to undergo an extended ophthalmologic examination as follows: distance and near visual acuities, Hertel exophthalmometry, corneal light reflex (Hirschberg test), ductions and versions in the 6 cardinal fields of gaze, eye deviation with prisms and alternate cover test in all of the 9-gaze directions with Maddox rod, degrees of incyclo/excyclotorsion with right and left eye fixation, horizontal and vertical deviation with Hess-Weiss coordimetry, degree of horizontal/vertical and incyclo/excyclotorsion deviation with Harms wall deviometry, and vertical deviation with Bielschowsky head-tilt test...
July 2015: Journal of Craniofacial Surgery
Dennis M Maddox, Gayle B Collin, Akihiro Ikeda, C Herbert Pratt, Sakae Ikeda, Britt A Johnson, Ron E Hurd, Lindsay S Shopland, Jürgen K Naggert, Bo Chang, Mark P Krebs, Patsy M Nishina
PURPOSE: The purpose of this study was to identify the molecular basis and characterize the pathological consequences of a spontaneous mutation named cone photoreceptor function loss 8 (cpfl8) in a mouse model with a significantly reduced cone electroretinography (ERG) response. METHODS: The chromosomal position for the recessive cpfl8 mutation was determined by DNA pooling and by subsequent genotyping with simple sequence length polymorphic markers in an F2 intercross phenotyped by ERG...
June 2015: Investigative Ophthalmology & Visual Science
Jitendra Jethani, Paaraj Dave
Ocular torsion can been measured by perimetry, double Maddox rod, Bagolini glasses, indirect ophthalmoscopy lens, slit-lamp biomicroscopy, synoptophore, and fundus photography. Wide variations have been reported in the measurement of the disk foveal angle (DFA) using fundus photography. We describe a technique for measuring the DFA, formed by a horizontal line extending from the center of the optic disk and a line from the center of disk to the fovea, using Microsoft PowerPoint and ImageJ software.
February 2015: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Justin D Marsh, Martin W Durkin, Andrew E Hack, Bethany B Markowitz, Edward W Cheeseman
BACKGROUND AND PURPOSE: The double Maddox rod is a commonly used instrument to test for cyclotorsion in the clinical setting. This paper assesses the ability of patients without torsional complaint to accurately demonstrate torsional status with varying degrees of induced hypertropia as tested by double Maddox rod. METHODS: Thirty-seven orthophoric subjects underwent double Maddox rod testing with vertical prism of 3(Δ), 10(Δ), 16(Δ), 20(Δ), and 30(Δ). Subjective torsion was recorded for each prism diopter...
2014: American Orthoptic Journal
Mingmei Liu, Jingcong Zhao, Wei Zhang
OBJECTIVE: To investigate the effect of superior oblique recession on the status of ocular torsion. METHODS: Twenty patients (31 eyes ) underwent superior oblique recession for treatment of superior oblique overacting, 11 cases had both eyes involvement while 9 had monocular.Objective cyclotorsion were examined pre-operation, as well as 1, 30, 90 days post-operation with fundus photograph. The photographs were transferred to a computer and then the fovea-disa angle (FDA) was measured by a software for drawing pictures...
July 2014: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Federico G Velez, Erica Oltra, Sherwin J Isenberg, Stacy L Pineles
BACKGROUND: Superior rectus transposition with or without medial rectus recession has been advocated for the treatment of abducens nerve palsy and esotropic Duane syndrome. Early reports have focused mainly on postoperative ocular alignment, but there is concern that superior rectus transposition may induce torsional misalignment. The purpose of this study was to evaluate torsional outcomes after superior rectus transposition surgery using prospective preoperative and postoperative torsional assessments...
October 2014: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Marc Dinkin
PURPOSE OF REVIEW: This article offers a pragmatic roadmap to the practicing neurologist on how to approach the patient with double vision. Strategies of history taking and examination techniques are reviewed, followed by a broad overview of the causes of diplopia organized by neuroanatomic localization. Diplopia may be the first symptom of serious vision or life-threatening neurologic disease, and its correct localization and diagnosis are therefore essential. The systems responsible for ocular movement and alignment in the vertical and horizontal plane include complex supranuclear circuitry, brainstem nuclei, cranial nerves III, IV, and VI, and their respective neuromuscular junctions and target muscles...
August 2014: Continuum: Lifelong Learning in Neurology
Yehoshua Almog, Arie Y Nemet, Yokrat Ton
BACKGROUND: To describe a modified technique to measure ocular cyclotorsion using only 1 Maddox rod and compare it with the traditional double Maddox rod test (DMR). METHODS: Ocular cyclotorsion was prospectively measured in 48 consecutive patients with superior oblique palsy. Four measurements were taken; 2 using 2 Maddox rods: (A) a red rod in front of the affected eye and a white rod in front of the fellow eye and (B) red rod in front of the sound eye and red in front of the affected eye...
December 2014: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Jose Luis Cebrian, Beatriz Antona, Ana Barrio, Enrique Gonzalez, Angel Gutierrez, Isabel Sanchez
PURPOSE: To determine the interexaminer and intraexaminer repeatability of the modified Thorington test (TH) for distance vision in young adults and to compare these results with those observed for the heterophoria tests most commonly used in clinical practice. Agreement among tests was also assessed. METHODS: Distance heterophoria was quantified on two separate occasions by two examiners in 110 subjects aged 18 to 32 years (mean, 19.74 years; SD, 2.5 years) using four different tests: cover test (CT) Von Graefe, Maddox rod, and modified TH...
July 2014: Optometry and Vision Science: Official Publication of the American Academy of Optometry
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