American Orthoptic Journal

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

Congenital cranial dysinnervation disorders (CCDD) is a new term describing a collection of non-progressive neurogenic syndromes. Initially referred to as congenital fibrosis syndrome, it was thought that the primary problem was extraocular muscular maldevelopment. Recent advancements in genetics and neuro-radiology have now determined the initial observation of fibrotic muscles is secondary to a primary lack of innervation from deficient, absent, or misguided cranial nerves. This presentation provides an overview of the known genes and phenotypes currently recognized within the CCDD domain...

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PURPOSE: To report four cases of early onset sixth-nerve palsy all of whom had eccentric fixation. METHODS: A retrospective case note review was undertaken of all cases presenting to the senior author's private and NHS practice with early onset sixth palsy between 2006 and 2012. As well as demographic information, details of ophthalmic, orthoptic, electrophysiological examinations, and radiological investigations that were extracted from the records. RESULTS: Four children with unilateral or asymmetric early onset sixth-nerve palsy were identified, of which three were congenital...

BACKGROUND: "Dragged-fovea diplopia syndrome" is a type of central binocular diplopia that is secondary to a foveal displacement, caused by epiretinal membranes (ERMs) or other macular diseases. Its management is difficult, because prisms are not effective. CASE REPORTS: Two cases of dragged-fovea diplopia syndrome were presented. Both patients were affected with a unilateral epiretinal membrane. Therefore, the pathophysiology underlying their diplopia was the conflict between central and peripheral fusion mechanisms...

BACKGROUND AND PURPOSE: To assess the possibility of determining the insertion distance from the limbus of previously operated extraocular rectus muscles (EOM) with the Heidelberg Spectralis anterior segment optical coherence tomography (AS-OCT). PATIENT AND METHOD: Subjects with a history of previous strabismus surgery underwent AS-OCT of the EOM before planned additional strabismus surgery. The EOM insertion distances from the limbus were measured pre-operatively on the AS-OCT and compared to the caliper distance measured during the strabismus surgery...

BACKGROUND AND PURPOSE: Early onset exodeviations in systemically and ocularly healthy young children, diagnosed at less than 1 year of age, may be of the constant, "infantile XT" type, or early X(T) type. The onset of common childhood X(T) is not clearly known. The purpose of this lecture is to discuss theories and characteristics of early onset exodeviations, and report on our observations of infantile XT and early X(T) at Children's Eye Care in Michigan. PATIENTS AND METHODS: A retrospective review of 470 cases of childhood exodeviations (ages 6 months to 15 years) were reviewed and met inclusion criteria of no prior surgical treatment, no ocular, CNS or craniofacial disease, and no significant prematurity...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND AND PURPOSE: Stereoacuity measurement is a common element of pediatric ophthalmic examinations. Although the Stereo Fly Test is routinely used to establish the presence of coarse stereopsis (3000 arcsecs), it often yields a false negative "pass" due to learned responses and non-stereoscopic cues. We developed and evaluated a modified Stereo Fly Test protocol aimed at increasing sensitivity, thus reducing false negatives. PATIENTS AND METHODS: The Stereo Fly Test was administered according to manufacturer instructions to 321 children aged 3-12 years...

BACKGROUND AND PURPOSE: Adequate cycloplegia and dilation are required for refraction and fundus exam in children. Standard practice is to instill cycloplegic drops in the inferior cul-de-sac, and this is often traumatic for children. Our study assesses the use of cyclopentolate on closed lids as a method of instillation for ensuring complete cycloplegia. PATIENTS AND METHOD: Ninety children presenting for annual refraction were enrolled. Three were excluded as they did not finish the testing...

INTRODUCTION AND PURPOSE: Anisometropia, a relative difference in the refractive state of the two eyes, is common in hyperopic patients. We investigated the association between ocular dominance (sighting dominance) and refractive asymmetry in patients with hyperopia. METHODS: This retrospective study included 223 hyperopic patients with a mean age of 10.1 ± 3.6 years (range 3 to 21 years). Refractive error was measured with cycloplegic refraction, and axial length was measured with IOLMaster® (Carl Zeiss Meditec, Dublin, CA)...

INTRODUCTION AND PURPOSE: To investigate the level of agreement between orthoptists and medical practitioners in the comprehensive eye examination of children seen in an orthoptist-led triage clinic. PATIENTS AND METHODS: Patient records over a 6-month period were retrospectively reviewed. Those with a presenting complaint related to vision or ocular motility were triaged into the orthoptist-led clinic and included in the study. Patients who did not meet the triage protocol and those who were not assessed by a medical practitioner at a subsequent appointment were excluded from analysis...

INTRODUCTION AND PURPOSE: To compare binocular vision measurements between Chronic Fatigue Syndrome (CFS) patients and healthy controls. METHODS: Forty-one CFS patients referred by the Reference Centre for Chronic Fatigue Syndrome of the Antwerp University Hospital and forty-one healthy volunteers, matched for age and gender, underwent a complete orthoptic examination. Data of visual acuity, eye position, fusion amplitude, stereopsis, ocular motility, convergence, and accommodation were compared between both groups...

INTRODUCTION AND PURPOSE: To investigate the efficacy of an amblyopia treatment program with both eyes open. METHODS: Ten subjects (mean age 20.5 ± 1.5 years) were enrolled. All subjects had un-remarkable ophthalmic examinations, but several subjects had minor refractive errors. Vision function was evaluated using the 3-D visual function trainer-ORTe. Brain measurements were made using functional near-infrared spectroscopy (fNIRS) to examine the oxygenated hemoglobin (HbO2 ) concentration change upon visual stimulus presentation...

INTRODUCTION AND PURPOSE: We describe the clinical characteristics of 252 patients with unilateral superior oblique palsy who underwent strabismus surgery. We assess if a predetermined surgical strategy, based on preoperative alignment and motility measurements, was effective in treating these patients. On this basis, the patients were divided into three different treatment groups. METHODS: Two-hundred fifty-two patients were identified retrospectively and classified into three groups according to the performed procedures: 1) inferior oblique weakening; 2) inferior rectus recession; 3) combined inferior oblique weakening and inferior rectus recession...