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  • Sensory Changes in Strabismus

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    Godwin Ovenseri
    139 vizualizări21 pagini
    Diplopia - occurs when a patient sees two images of one object in the visual space. Suppression may be defined as the active central inhibition of disparate and confusing images originating from the retina of the deviated eye.

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    Diplopia - occurs when a patient sees two images of one object in the visual space. Suppression may be defined as the active central inhibition of disparate and confusing images originating from the retina of the deviated eye.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    139 vizualizări21 pagini

    Sensory Changes in Strabismus

    Încărcat de

    Godwin Ovenseri
    Diplopia - occurs when a patient sees two images of one object in the visual space. Suppression may be defined as the active central inhibition of disparate and confusing images originating from the retina of the deviated eye.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 21

    DRGODWINOVENSERIOGBOMO,OD,MPH DEPTOFOPTOMETRY,UNIVERSITYOF BENIN,NIGERIA

    Binocularsensorychangesinstrabismus
    Diplopiaandconfusion. Suppressionofthebinocularfieldofthe strabismic eye. ARC

    Monocularsensorychangesinstrabismus
    Amblyopia Eccentricfixation
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    Diplopia occurswhenapatientseestwo imagesofoneobjectinthevisualspace.

    Patienthasaleftconvergentsquintofrecentonset
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    Becauseofthe recency ofthe strabismus,patient direction. isstilllikelytohave normalretinal correspondence, thusthetwofoveae havethesame visual

    Patienthasaleftconvergentsquintofrecent onset
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    Algorithmicapproachtoanalyzing doublevision.Forexplanation,see text.(ModifiedfromNoorden

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    Suppressionmaybedefinedastheactivecentral inhibitionofdisparateandconfusingimages originatingfromtheretinaofthedeviatedeye. Testsforsuppression:


    Binocularperimetry andhaploscopy Prismtest 4 BOprismtest MonocularVAmeasuredunderbinocularconditions WorthsFourDotTest
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    Atypeofretinalcorrespondence,inwhichthefoveas (foveae)ofthetwoeyesdonotgiverisetocommon visualdirectionalization,thefoveaofoneeye functioningdirectionallywithanextrafoveal areaof theothereye.(Hofstetter,2000) Abinocularconditioninwhichthereisachangein visualprojectionsuchthatthefoveaofthefixingeye hasacommonvisualdirectionwithanareaotherthan thefoveaofthedeviatingeye.Thepairingofallretinal elementsissimilarlychanged.(BOS,2001)
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    Visualfieldofapatientwithtropiahavingared filteroverthefixatingeye

    A:Homonymous(uncrosseddiplopia)=>Esotropia B:Heteronymous(crosseddiplopia)=>Exotropia C:Right:Suppression D:Normalretinalcorrespondence(NRC). E:Anomalousretinalcorrespondence(ARC)

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    AngleH Theangleofmisalignmentofthevisual axesasmeasuredbytheobserver.Theobjective angleofstrabismusandmeasuredbythecover testwithlooseprisms. AngleS thesubjectiveangleofstrabismus.The anglebetweenthevisualdirectionoftheretinal elementineacheyereceivingimagesofthe fixationobject.Shownbythesubjectiveseparation ofthediplopia. AngleA angleofanomaly
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    AngleA=angleH angleS. InNRC,angleH=angleS(angleA=0) InARC,angleA=angleH(i.e.angleS=0=> HARC)

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    11

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    12

    Harmoniousretinalcorrespondence the sensoryadaptationcompletelycompensates fortheangleofstrabismus.Thereisno subjectiveangleofstrabismus.AngleA= angleH.

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    Unharmoniousanomalouscorrespondence (UARC) thereisasmallsubjectiveangleof strabismus(angleS)whichissmallerthanthe objectiveangleofstrabismus(angleH)(i.e. angleS>angleH.

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    Atypeofanomalousretinalcorrespondencein whichtheangleofanomalyA>theobjectiveangle ofdeviationH. AnglesHandSareinoppositedirections. AngleA=AngleH+AngleS

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    Atypeofanomalousretinalcorrespondencein whichthesubjectiveangleofdeviation(S)>the objectiveangleofdeviation(H)andtheangleof anomaly(A)hasadirectionalvalueoppositeto eitherHorS(i.e.angleAisnegativesinceangleS> angleH.

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    Paradoxicaladaptationsaresometimesseen followingstrabismussurgery.

    ParadoxicaltypeIarisingfollowingsurgical correctionofesotropia
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    ParadoxicaltypeIIarisingfollowing surgicalcorrectionofexotropia
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    Correspondence

    ARC

    NRC

    HARC

    UARC

    Paradoxicaltype I

    Paradoxicaltype II

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    Amblyopia animpairmentofformvision withnoobviousorganiccause(strabismic amblyopia). Eccentricfixation Auniocular conditionin whichthereisfixationofanobjectbyapoint otherthanthefovea.Thispointadoptsthe principalvisualdirection.Thedegreeofthe eccentricfixationisdefinedbyitsdistance fromthefoveaindegrees
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    Auniocular conditioninwhichthereis fixationofanobjectbyaretinalpointother thanthefoveawithoutchangeinthe principalvisualdirection

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    AdaptedEvansBJW(2007).Pickwells BinocularVisionAnomalies.
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